Yongting Zhou, Mohammad Mofatteh, Zijie Zheng, Feng Liu, Sijie Zhou, Jicai Ma, Zile Yan, Yuzheng Lai, Weijiang Li, Weiying Chen, Mohamad Abdalkader, Robert W Regenhardt, Xiangmin Liu
{"title":"工作年龄脑卒中患者的血管内治疗:一项真实世界结果的多中心观察研究。","authors":"Yongting Zhou, Mohammad Mofatteh, Zijie Zheng, Feng Liu, Sijie Zhou, Jicai Ma, Zile Yan, Yuzheng Lai, Weijiang Li, Weiying Chen, Mohamad Abdalkader, Robert W Regenhardt, Xiangmin Liu","doi":"10.2147/TCRM.S508295","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The prevalence of acute ischemic stroke (AIS) is increasing among people of working age, posing socioeconomic and healthcare challenges. Inability to return to work can have significant negative consequences and contribute to the economic burden of stroke. Endovascular treatment (EVT) has been established as the standard of care for large vessel occlusion AIS patients. In this study, we aimed to identify factors predicting favorable outcome among working age AIS patients undergoing EVT.</p><p><strong>Patients and methods: </strong>We analyzed data from 309 patients from five comprehensive stroke centers between 2019 and 2023. All patients were working age (18<59) with symptoms onset of within 24 hours. Modified thrombolysis in cerebral infarction (mTICI) score of 2b-3 was considered as successful recanalization. We used 3-months mRS post-EVT to evaluate the outcome; mRS of 0-2 was defined as favorable outcome, whereas mRS of 3-6 was considered unfavorable outcome.</p><p><strong>Results: </strong>The unfavorable outcome group consisted of 150 patients, and 159 patients were in the favorable outcome group. More people in the unfavorable outcome group had diabetes (29.33% vs 15.72%, p=0.004) and hypertension (61.33% vs 40.88, p<0.001). A multivariable regression analysis demonstrated that several factors, including successful recanalization (odds ratio (OR) 5.298, 95% confidence interval (CI) 1.735-16.174, p=0.003), pre-EVT NIHSS (OR 0.892, 95% CI 0.852-0.934, p=0.000), baseline Alberta stroke program early CT score (ASPECTS) (OR 1.609, 95% CI 1.274-2.032, p=0.000), hypertension (OR 0.477, 95% CI 0.270-0.845, p=0.011), diabetes mellitus (OR 0.413, 95% CI 0.208-0.820, p=0.011), and symptomatic intracerebral hemorrhage (sICH) (OR 0.045, 95% CI 0.006-0.359, p=0.003) can predict the outcome of patients undergoing EVT.</p><p><strong>Conclusion: </strong>Favorable outcome of working age patients with AIS undergoing EVT can be predicted using multiple factors, including hypertension, diabetes mellitus, successful recanalization, pre-EVT NIHSS, baseline ASPECTS, and sICH.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1009-1019"},"PeriodicalIF":2.8000,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239903/pdf/","citationCount":"0","resultStr":"{\"title\":\"Endovascular Treatment in Stroke Patients of Working Age: A Multicenter Observational Study of Real-World Outcomes.\",\"authors\":\"Yongting Zhou, Mohammad Mofatteh, Zijie Zheng, Feng Liu, Sijie Zhou, Jicai Ma, Zile Yan, Yuzheng Lai, Weijiang Li, Weiying Chen, Mohamad Abdalkader, Robert W Regenhardt, Xiangmin Liu\",\"doi\":\"10.2147/TCRM.S508295\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The prevalence of acute ischemic stroke (AIS) is increasing among people of working age, posing socioeconomic and healthcare challenges. 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More people in the unfavorable outcome group had diabetes (29.33% vs 15.72%, p=0.004) and hypertension (61.33% vs 40.88, p<0.001). A multivariable regression analysis demonstrated that several factors, including successful recanalization (odds ratio (OR) 5.298, 95% confidence interval (CI) 1.735-16.174, p=0.003), pre-EVT NIHSS (OR 0.892, 95% CI 0.852-0.934, p=0.000), baseline Alberta stroke program early CT score (ASPECTS) (OR 1.609, 95% CI 1.274-2.032, p=0.000), hypertension (OR 0.477, 95% CI 0.270-0.845, p=0.011), diabetes mellitus (OR 0.413, 95% CI 0.208-0.820, p=0.011), and symptomatic intracerebral hemorrhage (sICH) (OR 0.045, 95% CI 0.006-0.359, p=0.003) can predict the outcome of patients undergoing EVT.</p><p><strong>Conclusion: </strong>Favorable outcome of working age patients with AIS undergoing EVT can be predicted using multiple factors, including hypertension, diabetes mellitus, successful recanalization, pre-EVT NIHSS, baseline ASPECTS, and sICH.</p>\",\"PeriodicalId\":22977,\"journal\":{\"name\":\"Therapeutics and Clinical Risk Management\",\"volume\":\"21 \",\"pages\":\"1009-1019\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-07-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239903/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutics and Clinical Risk Management\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/TCRM.S508295\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"Pharmacology, Toxicology and Pharmaceutics\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutics and Clinical Risk Management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/TCRM.S508295","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Pharmacology, Toxicology and Pharmaceutics","Score":null,"Total":0}
引用次数: 0
摘要
目的:急性缺血性卒中(AIS)在工作年龄人群中的患病率正在上升,对社会经济和医疗保健构成挑战。无法重返工作岗位会产生严重的负面后果,并增加中风带来的经济负担。血管内治疗(EVT)已被确立为AIS大血管闭塞患者的标准治疗方法。在这项研究中,我们旨在确定工作年龄AIS患者接受EVT的有利预后因素。患者和方法:我们分析了2019年至2023年间来自5个综合卒中中心的309名患者的数据。结果:不良结局组150例,良好结局组159例。不良结局组中糖尿病(29.33% vs 15.72%, p=0.004)和高血压(61.33% vs 40.88)较多。结论:工作年龄AIS行EVT患者的良好结局可通过多种因素预测,包括高血压、糖尿病、再通成功、EVT前NIHSS、基线ASPECTS和siich。
Endovascular Treatment in Stroke Patients of Working Age: A Multicenter Observational Study of Real-World Outcomes.
Purpose: The prevalence of acute ischemic stroke (AIS) is increasing among people of working age, posing socioeconomic and healthcare challenges. Inability to return to work can have significant negative consequences and contribute to the economic burden of stroke. Endovascular treatment (EVT) has been established as the standard of care for large vessel occlusion AIS patients. In this study, we aimed to identify factors predicting favorable outcome among working age AIS patients undergoing EVT.
Patients and methods: We analyzed data from 309 patients from five comprehensive stroke centers between 2019 and 2023. All patients were working age (18<59) with symptoms onset of within 24 hours. Modified thrombolysis in cerebral infarction (mTICI) score of 2b-3 was considered as successful recanalization. We used 3-months mRS post-EVT to evaluate the outcome; mRS of 0-2 was defined as favorable outcome, whereas mRS of 3-6 was considered unfavorable outcome.
Results: The unfavorable outcome group consisted of 150 patients, and 159 patients were in the favorable outcome group. More people in the unfavorable outcome group had diabetes (29.33% vs 15.72%, p=0.004) and hypertension (61.33% vs 40.88, p<0.001). A multivariable regression analysis demonstrated that several factors, including successful recanalization (odds ratio (OR) 5.298, 95% confidence interval (CI) 1.735-16.174, p=0.003), pre-EVT NIHSS (OR 0.892, 95% CI 0.852-0.934, p=0.000), baseline Alberta stroke program early CT score (ASPECTS) (OR 1.609, 95% CI 1.274-2.032, p=0.000), hypertension (OR 0.477, 95% CI 0.270-0.845, p=0.011), diabetes mellitus (OR 0.413, 95% CI 0.208-0.820, p=0.011), and symptomatic intracerebral hemorrhage (sICH) (OR 0.045, 95% CI 0.006-0.359, p=0.003) can predict the outcome of patients undergoing EVT.
Conclusion: Favorable outcome of working age patients with AIS undergoing EVT can be predicted using multiple factors, including hypertension, diabetes mellitus, successful recanalization, pre-EVT NIHSS, baseline ASPECTS, and sICH.
期刊介绍:
Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas.
The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature.
As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication.
The journal does not accept study protocols, animal-based or cell line-based studies.