Abstract:
BACKGROUND:It is unknown if improvements in ischemic stroke (IS) outcomes reported after cerebral reperfusion therapies (CRT) in developed countries are also applicable to the "real world" scenario of low and middle-income countries. We aimed to measure the long-term outcomes of severe IS treated or not with CRT in Brazil. METHODS:Patients from a stroke center of a state-run hospital were included. We compared the survival probability and functional status at 3 and 12 months in patients with severe IS treated or not with CRT. From 2010 to 2011, we performed intravenous reperfusion when patients arrived within 4.5 h time-window (IVT group) and after 2011, mechanical thrombectomy (MT) combined or not with intravenous alteplase (IAT group). Those who arrived >4.5 h in 2010-2011 and >6 h in 2012-2017 did not undergo CRT (NCRT group). RESULTS:From 2010 to 2017, we registered 917 patients: 74% (677/917) in the NCRT group, 19% (178/917) in the IVT group and 7% (62/917) in the IAT group. Compared to the NCRT group, IVT patients had a 28% higher (HR: 0.72; 95% CI 0.53-0.96) 3-month adjusted probability of survival and risk of functional dependence was 19% lower (adjusted RR: 0.81; 95% CI 0.73-0.91). For those who underwent MT, the adjusted probability of survival was 59 % higher (HR: 0.41; 95% CI 0.21-0.77) and the risk of functional dependence was 21% lower (adjusted RR: 0.79; 95% CI 0.66-094). These outcomes remained significantly better throughout the first year. CONCLUSION:CRT led to better outcomes in patients with severe IS in Brazil.
journal_name
Curr Neurovasc Resjournal_title
Current neurovascular researchauthors
Schulz VC,de Magalhaes PSC,Carneiro CC,da Silva JIT,Silva VN,Guesser VV,Safanelli J,Diegoli H,Liberato RB,Lopes CCC,de Souza A,de França PHC,Conforto AB,Cabral NLdoi
10.2174/1567202617666200521083132subject
Has Abstractpub_date
2020-01-01 00:00:00pages
361-375issue
4eissn
1567-2026issn
1875-5739pii
CNR-EPUB-106815journal_volume
17pub_type
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