实现完全再通是预测老年人血栓切除术预后良好的最佳因素。前瞻性单中心研究的结果。

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY
Manar Abomulay, Philippe Desfontaines, Carla Ciobanu, Denis Brisbois, Olivier Cornet, François Dister, François Delvoye
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引用次数: 0

摘要

背景和目的:对于80岁以上人群中与大血管闭塞(LVO)相关的急性缺血性卒中(AIS)进行血管内治疗(EVT)后预后良好(GO)的预测因素知之甚少。我们评估了在lvo相关AIS急性期接受治疗的患者的前瞻性登记中GO的人口学和程序预测因素。方法:GO被定义为3个月的改良Rankin量表(mRS)[公式:见文本]3或相当于卒中前mRS.进行单因素(UVA)和多因素(MVA)分析以评估各因素对结果的独立影响。通过计算标准化差异(StD)来评估组间差异的大小。StD为>、0、2的变量纳入MVA。结果:182例≥80岁患者中,31.3%(57/182)出现3个月GO。预后不良(PO)组TICI≥2c-3的比例明显低于GO组(52% vs 78.9%, StD = 0.591)。在单变量logistic回归模型中,TICI≥2c-3与GO发生几率增加277%相关(OR = 3.77, 95%CI 1.79-7.97, P)。结论:我们表明,达到2c-3的TICI评分似乎是老年人群预后的最佳预测因素。在这一组中,应尽一切努力实现优良的再通化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Achieving complete recanalization is the best predicting factor of good outcome for thrombectomy in the elderly. Results from a prospective monocentric study.

Background and aims: Little is known about predicting factors for a good outcome (GO) after endovascular treatment (EVT) performed for acute ischemic stroke (AIS) related to large vessel occlusion (LVO) in the over-80s population. We evaluate demographic and procedural predictors of GO from our prospective registry of patients treated during the acute phase of an LVO-related AIS.

Methods: GO was defined as a 3-month modified Rankin scale (mRS) [Formula: see text] 3 or equivalent to pre-stroke mRS. Univariate (UVA) and multivariate (MVA) analysis were performed to assess the factors' independent effect on the outcome. The magnitude of the between-group differences was assessed by calculating the standardized differences (StD). Variables with StD >0,2 were included in the MVA.

Results: From 182 patients aged ≥ 80, 3-month GO was observed in 31.3% (57/182). The proportion of TICI ≥ 2c-3 was significantly lower in the poor outcome (PO) group compared to the GO group (52% versus 78.9%, StD = 0.591). In univariate logistic regression model, TICI ≥ 2c-3 is associated with a 277% increase in the chances of a GO (OR = 3.77, 95%CI 1.79-7.97, P < 0.001). This association remained significant in multivariate logistic regression model (aOR = 0.77, 95%CI 0.66-0.89, P = 0.000501) even when a hemorrhagic transformation (HT) occurs (p het = 0.57948).

Conclusions: We show that achieving a TICI score of 2c-3 seems to be the best predictive factor for the outcome in the elderly population. In this group, every effort should be made to achieve excellent recanalization.

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来源期刊
Acta neurologica Belgica
Acta neurologica Belgica 医学-临床神经学
CiteScore
4.20
自引率
3.70%
发文量
300
审稿时长
6-12 weeks
期刊介绍: Peer-reviewed and published quarterly, Acta Neurologica Belgicapresents original articles in the clinical and basic neurosciences, and also reports the proceedings and the abstracts of the scientific meetings of the different partner societies. The contents include commentaries, editorials, review articles, case reports, neuro-images of interest, book reviews and letters to the editor. Acta Neurologica Belgica is the official journal of the following national societies: Belgian Neurological Society Belgian Society for Neuroscience Belgian Society of Clinical Neurophysiology Belgian Pediatric Neurology Society Belgian Study Group of Multiple Sclerosis Belgian Stroke Council Belgian Headache Society Belgian Study Group of Neuropathology
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