Abstract：
BACKGROUND AND PURPOSE:Current demographic changes indicate that more people will be care-dependent due to increasing life expectancy. Little is known about impact of preexisting dependency on stroke outcome after endovascular treatment (EVT). METHODS:We compared prospectively collected baseline and outcome data of previously dependent vs. independent stroke patients (prestroke modified Rankin Scale score of 3-5 vs. 0-2) treated with EVT. Outcome measures were favorable 3-month outcome (mRS ≤ 3 for previously dependent and mRS ≤ 2 for independent patients, respectively), death and symptomatic intracranial hemorrhage (sICH). RESULTS:Among 1247 patients, 84 (6.7%) were dependent before stroke. They were older (81 vs. 72 years of age), more often female (61.9% vs. 46%), had a higher stroke severity at baseline (NIHSS 18 vs. 15 points), more often history of previous stroke (32.9% vs. 9.1%) and more vascular risk factors than independent patients. Favorable outcome and mortality were to the disadvantage of independent patients (26.2% vs. 44.4% and 46.4% vs. 25.5%, respectively), whereas sICH was comparable in both cohorts (4.9% vs. 5%). However, preexisting dependency was not associated with clinical outcome and mortality after adjusting for outcome predictors (OR 1.076, 95% CI 0.612-1.891; p = 0.799 and OR 1.267, 95% CI 0.758-2.119; p = 0.367, respectively). CONCLUSION:Our study underscores the need for careful selection of care-dependent stroke patients when considering EVT, given a less favorable outcome observed in this cohort. Nonetheless, EVT should not systematically be withheld in patients with preexisting disability, since prior dependency does not significantly influence outcome.
journal_name
J Neuroljournal_title
Journal of neurologyauthors
Oesch L,Arnold M,Bernasconi C,Kaesmacher J,Fischer U,Mosimann PJ,Jung S,Meinel T,Goeldlin M,Heldner M,Volbers B,Gralla J,Sarikaya Hdoi
10.1007/s00415-020-10172-3subject
Has Abstractpub_date
2020-08-31 00:00:00eissn
0340-5354issn
1432-1459pii
10.1007/s00415-020-10172-3pub_type
杂志文章abstract：:The gut with its variety of microbiota may serve as an etiological origin of diseases. Gut microbes may also play a role in the pathogenesis of diseases beyond their simple nutritional maintenance and support. For example, gut protein aggregation, possibly aided by microbes as well as nasal influences, might be linked...
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pub_type： 杂志文章
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