Do initial clinical symptoms affect the outcome of ischemic stroke patients with recanalization treatment?


Authors: S. Halúsková 1;  R. Herzig 1;  D. Krajíčková 1;  A. Hamza 2;  A. Krajina 3;  V. Chovanec 3;  M. Lojík 3;  J. Raupach 3;  O. Renc 3;  L. Šimůnek 1;  E. Vítková 1;  L. Sobíšek 1;  M. Vališ 1
Authors‘ workplace: Neurologická klinika, Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové 1;  Neurologická klinika LF UK Hradec Králové 2;  Radiologická klinika, Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové 3
Published in: Cesk Slov Neurol N 2021; 84(5): 456-464
Category: Original Paper
doi: 10.48095/cccsnn2021456

Overview

Aim: The aim was to assess the dependency of the 90-day clinical outcome on the initial symptoms of ischemic stroke (IS) in patients treated with intravenous thrombolysis (IVT) and/or endovascular therapy (EVT). Materials and methods: In a retrospective, observational, one-center study, we assessed the effect of initial IS symptoms, achieved times and degree of recanalization on a 90-day clinical outcome in a set of 809 IS patients treated with IVT and/or EVT. Results: In the IVT group, age (odds ratio [OR] = 0.94, 95% confidence interval [CI]: 0.91–0.96), baseline neurological deficit (OR = 0.91, 95% CI: 0.86–0.96), and the presence of limb paresis (OR = 0.51, 95% CI: 0.25–0.97) were identified as significant negative predictors of a good 90-day clinical outcome. In the EVT (± IVT) group, age (OR = 0.93, 95% CI: 0.91–0.95) and initial neurological deficit (OR = 0.84, 95% CI: 0.80–0.89) were identified as significant negative predictors and successful recanalization (OR = 4.31, 95% CI: 2.44–7.81) as a significant positive predictor of a good 90-day clinical outcome (P < 0.05 in all cases). Conclusions: Our results showed that the presence of limb paresis was associated with a worse clinical outcome in patients treated with IVT alone, while the presence of other IS symptoms did not affect a 90-day clinical outcome in patients treated with recanalization therapy

Keywords:

acute ischemic stroke – clinical symptoms – intravenous thrombolysis – endovascular therapy – clinical outcome


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Paediatric neurology Neurosurgery Neurology

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