Excellent Recanalization and Small Core Volumes Are Associated With Favorable AM-PAC Score in Patients With Acute Ischemic Stroke Secondary to Large Vessel Occlusion

被引：4

作者：

Yedavalli, Vivek ^{[1
]}

Koneru, Manisha ^{[2
]}

Hoseinyazdi, Meisam ^{[1
]}

Copeland, Karen ^{[3
]}

Xu, Risheng ^{[4
]}

Luna, Licia ^{[1
]}

Caplan, Justin ^{[4
]}

Dmytriw, Adam ^{[5
,6
]}

Guenego, Adrien ^{[7
]}

Heit, Jeremy ^{[8
]}

Albers, Gregory ^{[9
]}

Wintermark, Max ^{[10
]}

Gonzalez, Fernando ^{[4
]}

Urrutia, Victor ^{[11
]}

Huang, Judy ^{[4
]}

Leigh, Richard ^{[11
]}

Marsh, Elisabeth ^{[11
]}

Llinas, Rafael ^{[11
]}

Hernandez, Marlis Gonzalez ^{[11
]}

Hillis, Argye ^{[11
]}

机构：

[1] Johns Hopkins Sch Med, Dept Radiol & Radiol Sci, Phipps B122-D, Baltimore, MD 21287 USA

[2] Rowan Univ, Cooper Med Sch, Camden, NJ USA

[3] Boulder Stat, Boulder, CO USA

[4] Johns Hopkins Sch Med, Dept Neurosurg, Baltimore, MD USA

[5] Massachusetts Gen Hosp, Dept Neuroradiol, Boston, MA USA

[6] Harvard Med Sch, Boston, MA USA

[7] Univ Libre Bruxelles, Erasme Hosp, Radiol Dept, Brussels, Belgium

[8] Stanford Univ, Sch Med, Dept Radiol, Palo Alto, CA USA

[9] Stanford Univ, Sch Med, Dept Pediat, Stanford, CA 94305 USA

[10] Univ Texas MD Anderson Canc Ctr, Dept Radiol, Houston, TX USA

[11] Johns Hopkins Sch Med, Dept Neurol, Baltimore, MD USA

来源：

ARCHIVES OF REHABILITATION RESEARCH AND CLINICAL TRANSLATION | 2023年 / 5卷 / 04期

关键词：

Acute ischemic stroke; perfusion imaging; CT; AMPAC; Rehabilitation; ENDOVASCULAR TREATMENT; TICI; 3; 2B; THROMBECTOMY; PERFUSION; THROMBOLYSIS; THERAPY; TRIAL; CARE; 2C;

D O I：

10.1016/j.arrct.2023.100306

中图分类号：

R49 [康复医学];

学科分类号：

100215 ;

摘要：

Objective: To assess pretreatment and interventional parameters as predictors of favorable Activity Measure for Post-Acute Care (AM-PAC) scores for optimal discharge planning.Design: In this prospectively collected, retrospectively reviewed multicenter study from 9/1/2017 to 9/22/2022, patients were dichotomized into favorable and unfavorable AM-PAC. Multivariate logistic regression and receiver operator characteristics analyses were performed for the identified significant variables. A P value of <=.05 was significant.Setting: Hospitalized care.Participants: In total, 229 patients (mean +/- SD 70.65 +/- 15.2 [55.9% women]) met our inclusion criteria. Inclusion criteria were (a) computed tomography (CT) angiography confirmed LVO from 9/1/2017 to 9/22/2022; (b) diagnostic CT perfusion; and (c) available AM-PAC scores.Interventions: None.Main outcome measures: Favorable AM-PAC, defined as a daily activity score >= 19 and basic mobility score of >= 17.Results: Patients with favorable AM-PAC were younger (61.3 vs 70.7, P<.001), had lower admission glucose (mean, 124 vs 136, P=.042), lower blood urea nitrogen (mean, 15.59 vs 19.11, P<.001), and lower admission National Institutes of Health Stroke Scale (NIHSS) (mean, 10.58 vs 16.15, P<.001). No differences in sex were noted. Multivariate regression analyses revealed age, admission NIHSS, relative cerebral blood flow (rCBF) <30% volume, and modified thrombolysis in cerebral infarction (mTICI) score to be independent predictors of favorable AM-PAC (P<.047 for all predictors). The combined model revealed an area under the curve (AUC) of 0.83 (IQR 0.75-0.86).Conclusion: Excellent recanalization, smaller core volumes, younger age, and lower stroke severity independently predict favorable outcomes as measured by AM-PAC.

引用

页数：7

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