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Clinical outcome after thrombectomy in patients with stroke with premorbid modified rankin scale scores of 3 and 4: a cohort study with 136 patients

BACKGROUND AND PURPOSE: We aimed to analyze the clinical outcome after mechanical thrombectomy in patients with premorbid mRS 3 and 4 because there are currently no data on this patient group. - MATERIALS AND METHODS: Between January 2009 and November 2017, all patients with premorbid mRS 3 or 4 und...

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Main Authors: Seker, Fatih (Author) , Pfaff, Johannes (Author) , Schönenberger, Silvia (Author) , Herweh, Christian (Author) , Nagel, Simon (Author) , Ringleb, Peter A. (Author) , Bendszus, Martin (Author) , Möhlenbruch, Markus Alfred (Author)
Format: Article (Journal)
Language:English
Published: February 13, 2019
In: American journal of neuroradiology
Year: 2019, Volume: 40, Issue: 2, Pages: 283-286
ISSN:1936-959X
DOI:10.3174/ajnr.A5920
Online Access:Verlag, Volltext: https://doi.org/10.3174/ajnr.A5920
Verlag, Volltext: http://www.ajnr.org/content/40/2/283
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Author Notes:F. Seker, J. Pfaff, S. Schönenberger, C. Herweh, S. Nagel, P.A. Ringleb, M. Bendszus, and M.A. Möhlenbruch
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Summary:BACKGROUND AND PURPOSE: We aimed to analyze the clinical outcome after mechanical thrombectomy in patients with premorbid mRS 3 and 4 because there are currently no data on this patient group. - MATERIALS AND METHODS: Between January 2009 and November 2017, all patients with premorbid mRS 3 or 4 undergoing mechanical thrombectomy due to anterior circulation stroke were selected. Good outcome was defined as a clinical recovery to the status before stroke onset (ie, equal premorbid mRS and mRS at 90 days). In addition, mortality at discharge and at 90 days was analyzed. - RESULTS: One hundred thirty-six patients were included, of whom 81.6% presented with premorbid mRS 3; and 18.4%, with premorbid mRS 4; 24.0% of patients with premorbid mRS 4 achieved clinical recovery compared with 20.7% of patients with premorbid mRS 3 (P = .788). However, the proportion of hospital mortality and mortality at 90 days was nonsignificant, but markedly higher in patients with premorbid mRS 4. Multivariate analysis identified low NIHSS scores (OR, 0.92; 95% CI, 0.85-0.99; P = .040), high ASPECTS (OR, 1.45; 95% CI, 1.02-2.16; P = .049), and TICI 2b-3 (OR, 7.11; 95% CI, 1.73-49.90; P = .017) as independent predictors of good outcome. - CONCLUSIONS: Good outcome in patients with premorbid mRS 3 and 4 is less frequent compared with premorbid mRS 0-2. Nevertheless, about 20% of the patients return to their premorbid mRS, which may justify endovascular treatment. The most important predictor of good outcome is successful recanalization.
Item Description:Gesehen am 29.11.2019
Physical Description:Online Resource
ISSN:1936-959X
DOI:10.3174/ajnr.A5920

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