Functional long-term outcome following endovascular thrombectomy in patients with acute ischemic stroke

Neurological Research and Practice, vol. 6, pp. 2

Abstract

Endovascular thrombectomy (EVT) is the most effective treatment for acute ischemic stroke caused by large vessel occlusion (LVO). Yet, long-term outcome (LTO) and health-related quality of life (HRQoL) in these patients have rarely been addressed, as opposed to modified Rankin scale (mRS) recordings. We analysed demographic data, treatment and neuroimaging parameters in 694 consecutive stroke patients in a maximum care hospital. In 138 of these patients with respect on receipt of written informed consent, LTO and HRQoL were collected over a period of 48 months after EVT using a standardised telephone survey (median 2.1 years after EVT). Age < 70 years (OR 4.82), lower NIHSS on admission (OR 1.11), NIHSS ≤ 10 after 24 h (OR 11.23) and complete recanalisation (mTICI3) (OR 7.79) were identified as independent predictors of favourable LTO. Occurrence of an infection requiring treatment within the first 72 h was recognised as a negative predictor for good long-term outcome (OR 0.22). Patients with mRS > 2 according to the telephone survey more often had complaints regarding mobility, self-care, and usual activity domains of the HRQoL. Our results underline a sustainable positive effect of effective EVT on the quality of life in LVO stroke. Additionally, predictive parameters of outcome were identified, that may support clinical decision making in LVO stroke.

Authors 10

1. Andreas Rogalewski corresponding

   Bielefeld University

   Affiliation as printed

   Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Schildescher Str. 99, 33611, Bielefeld, Germany. andreas.rogalewski@sankt-elisabeth-hospital.de

   Department of Neurology, Sankt Elisabeth Hospital Gütersloh, Catholic Hospital Association of East Westfalia (KHO), Gütersloh, Germany. andreas.rogalewski@sankt-elisabeth-hospital.de

2. Nele Klein Aachen Department of Neurology, Medical Faculty

   RWTH Aachen University · Bielefeld University

   Affiliation as printed

   Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Schildescher Str. 99, 33611, Bielefeld, Germany

   Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany

3. Anja Friedrich

   Bielefeld University

   Affiliation as printed

   Department of Psychology, Bielefeld University, Bielefeld, Germany

4. Alkisti Kitsiou

   Bielefeld University

   Affiliation as printed

   Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Schildescher Str. 99, 33611, Bielefeld, Germany

5. Marie Schäbitz

   Bielefeld University

   Affiliation as printed

   Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Schildescher Str. 99, 33611, Bielefeld, Germany

6. Frédéric Zuhorn

   Bielefeld University

   Affiliation as printed

   Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Schildescher Str. 99, 33611, Bielefeld, Germany

7. Burkhard Gess Aachen Department of Neurology, Medical Faculty

   RWTH Aachen University · Bielefeld University

   Affiliation as printed

   Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Schildescher Str. 99, 33611, Bielefeld, Germany

   Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany

8. Björn Berger

   Bielefeld University · Evangelisches Krankenhaus Bielefeld

   Affiliation as printed

   Department of Neuroradiology, Evangelisches Klinikum Bethel EvKB, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany

9. Randolf Klingebiel

   Bielefeld University · Evangelisches Krankenhaus Bielefeld

   Affiliation as printed

   Department of Neuroradiology, Evangelisches Klinikum Bethel EvKB, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany

10. Wolf‐Rüdiger Schäbitz

    Bielefeld University

    Affiliation as printed

    Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL of the University Bielefeld, Campus Bielefeld-Bethel, Schildescher Str. 99, 33611, Bielefeld, Germany