Clinical Outcome of Patients With Large Vessel Occlusion and Low National Institutes of Health Stroke Scale Scores Subanalysis of the RESCUE-Japan Registry 2

被引：33

作者：

Saito, Takuya ^{[1
]}

Itabashi, Ryo ^{[2
]}

Yazawa, Yukako ^{[1
]}

Uchida, Kazutaka ^{[3
]}

Yamagami, Hiroshi ^{[5
]}

Sakai, Nobuyuki ^{[6
]}

Morimoto, Takeshi ^{[4
]}

Yoshimura, Shinichi ^{[3
]}

机构：

[1] Kohnan Hosp, Dept Stroke Neurol, Sendai, Miyagi, Japan

[2] Iwate Med Univ, Sch Med, Div Neurol & Gerontol, Dept Internal Med, 2-1-1 Yahaba, Yahaba, Iwate 028, Japan

[3] Hyogo Coll Med, Dept Neurosurg, Nishinomiya, Hyogo, Japan

[4] Hyogo Coll Med, Dept Clin Epidemiol, Nishinomiya, Hyogo, Japan

[5] Natl Hosp Org Osaka Natl Hosp, Dept Stroke Neurol, Osaka, Japan

[6] Kobe City Med Ctr Gen Hosp, Dept Neurosurg, Kobe, Hyogo, Japan

来源：

STROKE | 2020年 / 51卷 / 05期

关键词：

endovascular procedures; prognosis; reperfusion; tissue-type plasminogen activator; ACUTE ISCHEMIC-STROKE; MECHANICAL THROMBECTOMY; NIHSS SCORE; MINIMAL SYMPTOMS; ALTEPLASE; GUIDELINES; MANAGEMENT; INTENTION; TRIAL;

D O I：

10.1161/STROKEAHA.119.028562

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose- The treatment and prognosis of acute large vessel occlusion with mild symptoms have not been sufficiently studied. The present study aimed to investigate the clinical or radiological predictors of clinical outcome in patients with stroke with mild symptoms due to acute large vessel occlusion. Methods- Of 2420 patients with acute large vessel occlusion in the RESCUE-Japan Registry 2 (Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism-Japan Registry 2), a multicenter prospective registry in Japan, patients with modified Rankin Scale scores of 0 to 2 before onset and initial National Institutes of Health Stroke Scale (NIHSS) scores of 0 to 5 were examined in post hoc analysis. We examined the clinical and radiological characteristics associated with a favorable outcome (modified Rankin Scale score, 0-2 at 90 days) using multivariate analysis, as well as the factors associated with a favorable outcome in patients treated with endovascular therapy. Results- We analyzed 272 patients (median age, 73 years; median NIHSS score on admission, 3). Eighty-six (31.6%) patients were treated with intravenous recombinant tissue-type plasminogen activator, 54 (19.9%) underwent endovascular therapy, and 208 (76.5%) showed a favorable outcome. In multivariate analysis, age <75 years (odds ratio [OR], 2.42 [95% CI, 1.30-4.50]), initial NIHSS score 0 to 3 (OR, 3.08 [95% CI, 1.59-5.98]), intravenous recombinant tissue-type plasminogen activator (OR, 2. 86 [95% CI, 1.32-6.21]), and blood glucose level <= 140 mg/dL (OR, 2.37 [95% CI, 1.22-4.60]) were independently associated with a favorable outcome. However, endovascular therapy was not associated with a favorable outcome (OR, 1.65 [95% CI, 0.71-3.88]). Among 54 patients treated with endovascular therapy, good reperfusion status was more common in the favorable outcome group (88.6% versus 60.0%; P<0.05). Conclusions- Younger age, lower initial NIHSS score, intravenous recombinant tissue-type plasminogen activator, and absence of hyperglycemia were independently associated with a favorable outcome in patients with acute large vessel occlusion with low NIHSS scores. Registration- URL: ; Unique identifier: NCT02419794.

引用

页码：1458 / 1463

页数：6

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