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Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry
OBJECTIVES: We aimed to determine predictors of mortality within 90 days and develop a simple score for patients with mechanical thrombectomy (MT). DESIGN: Analysis of a multicentre prospective registry. SETTING: In six participating centres, patients who had an acute ischaemic stroke (AIS) treated...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021751/ https://www.ncbi.nlm.nih.gov/pubmed/33795300 http://dx.doi.org/10.1136/bmjopen-2020-043415 |
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author | Li, Hao Ye, Shi-sheng Wu, Yuan-Ling Huang, Sheng-Ming Li, Yong-Xin Lu, Kui Huang, Jing-Bo Chen, Lve Li, Hong-Zhuang Wu, Wen-Jun Wu, Zhi-Lin Wu, Jian-Zhou Zhong, Wang-Tao Xian, Wen-Chuan Liao, Feng Tung, Tao-Hsin Wu, Qiao-Ling Chen, Hai Yuan, Li Yang, Zhi Huang, Li-An |
author_facet | Li, Hao Ye, Shi-sheng Wu, Yuan-Ling Huang, Sheng-Ming Li, Yong-Xin Lu, Kui Huang, Jing-Bo Chen, Lve Li, Hong-Zhuang Wu, Wen-Jun Wu, Zhi-Lin Wu, Jian-Zhou Zhong, Wang-Tao Xian, Wen-Chuan Liao, Feng Tung, Tao-Hsin Wu, Qiao-Ling Chen, Hai Yuan, Li Yang, Zhi Huang, Li-An |
author_sort | Li, Hao |
collection | PubMed |
description | OBJECTIVES: We aimed to determine predictors of mortality within 90 days and develop a simple score for patients with mechanical thrombectomy (MT). DESIGN: Analysis of a multicentre prospective registry. SETTING: In six participating centres, patients who had an acute ischaemic stroke (AIS) treated by MT between March 2017 and May 2018 were documented prospectively. PARTICIPANTS: 224 patients with AIS were treated by MT. RESULTS: Of 224 patients, 49 (21.9%) patients died, and 87 (38.8%) were independent. Variables associated with 90-day mortality were age, previous stroke, admission National Institutes of Health Stroke Scale (NIHSS), fasting blood glucose and occlusion site. Logistic regression identified four variables independently associated with 90-day mortality: age ≥80 years (OR 3.26, 95% CI 1.45 to 7.33), previous stroke (OR 2.33, 95% CI 1.04 to 5.21), admission NIHSS ≥18 (OR 2.37, 95% CI 1.13 to 4.99) and internal carotid artery or basilar artery occlusion (OR 2.92, 95% CI 1.34 to 6.40). Using these data, we developed predicting 90-day mortality of AIS with MT (PRACTICE) score ranging from 0 to 6 points. The receiver operator curve analysis found that PRACTICE score (area under the curve (AUC)=0.744, 95% CI 0.669 to 0.820) was numerically better than iScore (AUC=0.661, 95% CI 0.577 to 0.745) and Predicting Early Mortality of Ischemic Stroke score (AUC=0.638, 95% CI 0.551 to 0.725) for predicting 90-day mortality. CONCLUSIONS: We developed a simple score to estimate the 90-day mortality of patients who had an AIS treated with MT. But the score needs to be prospectively validated. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR-OOC-17013052). |
format | Online Article Text |
id | pubmed-8021751 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-80217512021-04-26 Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry Li, Hao Ye, Shi-sheng Wu, Yuan-Ling Huang, Sheng-Ming Li, Yong-Xin Lu, Kui Huang, Jing-Bo Chen, Lve Li, Hong-Zhuang Wu, Wen-Jun Wu, Zhi-Lin Wu, Jian-Zhou Zhong, Wang-Tao Xian, Wen-Chuan Liao, Feng Tung, Tao-Hsin Wu, Qiao-Ling Chen, Hai Yuan, Li Yang, Zhi Huang, Li-An BMJ Open Neurology OBJECTIVES: We aimed to determine predictors of mortality within 90 days and develop a simple score for patients with mechanical thrombectomy (MT). DESIGN: Analysis of a multicentre prospective registry. SETTING: In six participating centres, patients who had an acute ischaemic stroke (AIS) treated by MT between March 2017 and May 2018 were documented prospectively. PARTICIPANTS: 224 patients with AIS were treated by MT. RESULTS: Of 224 patients, 49 (21.9%) patients died, and 87 (38.8%) were independent. Variables associated with 90-day mortality were age, previous stroke, admission National Institutes of Health Stroke Scale (NIHSS), fasting blood glucose and occlusion site. Logistic regression identified four variables independently associated with 90-day mortality: age ≥80 years (OR 3.26, 95% CI 1.45 to 7.33), previous stroke (OR 2.33, 95% CI 1.04 to 5.21), admission NIHSS ≥18 (OR 2.37, 95% CI 1.13 to 4.99) and internal carotid artery or basilar artery occlusion (OR 2.92, 95% CI 1.34 to 6.40). Using these data, we developed predicting 90-day mortality of AIS with MT (PRACTICE) score ranging from 0 to 6 points. The receiver operator curve analysis found that PRACTICE score (area under the curve (AUC)=0.744, 95% CI 0.669 to 0.820) was numerically better than iScore (AUC=0.661, 95% CI 0.577 to 0.745) and Predicting Early Mortality of Ischemic Stroke score (AUC=0.638, 95% CI 0.551 to 0.725) for predicting 90-day mortality. CONCLUSIONS: We developed a simple score to estimate the 90-day mortality of patients who had an AIS treated with MT. But the score needs to be prospectively validated. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR-OOC-17013052). BMJ Publishing Group 2021-04-01 /pmc/articles/PMC8021751/ /pubmed/33795300 http://dx.doi.org/10.1136/bmjopen-2020-043415 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Neurology Li, Hao Ye, Shi-sheng Wu, Yuan-Ling Huang, Sheng-Ming Li, Yong-Xin Lu, Kui Huang, Jing-Bo Chen, Lve Li, Hong-Zhuang Wu, Wen-Jun Wu, Zhi-Lin Wu, Jian-Zhou Zhong, Wang-Tao Xian, Wen-Chuan Liao, Feng Tung, Tao-Hsin Wu, Qiao-Ling Chen, Hai Yuan, Li Yang, Zhi Huang, Li-An Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry |
title | Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry |
title_full | Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry |
title_fullStr | Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry |
title_full_unstemmed | Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry |
title_short | Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry |
title_sort | predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021751/ https://www.ncbi.nlm.nih.gov/pubmed/33795300 http://dx.doi.org/10.1136/bmjopen-2020-043415 |
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