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Predictors of Mortality in Acute Ischemic Stroke Intervention: Analysis of the North American Solitaire Acute Stroke Registry.

Abstract：

BACKGROUND AND PURPOSE:Failure to recanalize predicts mortality in acute ischemic stroke. In the North American Solitaire Acute Stroke registry, we investigated parameters associated with mortality in successfully recanalized patients. METHODS:Logistic regression was used to evaluate baseline characteristics and recanalization parameters for association with 90-day mortality. A multivariable model was developed based on backward selection with retention criteria of P<0.05 from factors with at least marginal significance (P≤0.10), then refit to minimize the number of excluded cases (missing data). RESULTS:Successfully recanalized patients had lower mortality (25.2% [59/234] versus 46.9% [38/81] P<0.001). There was no difference in symptomatic intracranial hemorrhage between patients with successful versus failed recanalization (9% [21/234] versus 14% [11/79]; P=0.205). However, mortality was significantly higher in patients with symptomatic intracranial hemorrhage (72% [23/32] versus 26% [73/281]; P<0.001). Proximal occlusion (internal carotid artery or vertebrobasilar), initial National Institutes of Health Stroke Scale≥18, use of rescue therapy (P<0.05), and 3+ passes (P<0.10) were associated with mortality in recanalized patients. In the multivariate model with good predictive power (c index=0.72), proximal occlusion, initial National Institutes of Health Stroke Scale≥18, and use of rescue therapy remained significant independent predictors of 90-day mortality. CONCLUSIONS:Failure to recanalize and presence of symptomatic intracranial hemorrhage resulted in increased mortality. Despite successful recanalization, proximal occlusion, high National Institutes of Health Stroke Scale, and need for rescue therapy were predictors of mortality.

journal_name

Stroke

journal_title

Stroke

authors

Linfante I,Walker GR,Castonguay AC,Dabus G,Starosciak AK,Yoo AJ,Abou-Chebl A,Britz GW,Marden FA,Alvarez A,Gupta R,Sun CH,Martin C,Holloway WE,Mueller-Kronast N,English JD,Malisch TW,Bozorgchami H,Xavier A,Rai AT,F

doi

10.1161/STROKEAHA.115.009530

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

2305-8

issue

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.115.009530

journal_volume

pub_type

杂志文章,多中心研究

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Predictors of Mortality in Acute Ischemic Stroke Intervention: Analysis of the North American Solitaire Acute Stroke Registry.