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Admission Motor Streng.h g.ade Predicts Mortality in Patients with Acute Ischemic Stroke Underg.ing.Mechanical Thrombectomy

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Neuroscience & Medicine 2013年第1期4卷 1-6页

作者： Vishnumurthy Shushrutha Hedna Aakash N. Bodhit Saeed Ansari Adam D Falchook latha g. stead Sharathchandra Bidari Brian L Hoh Kenneth M Heilman Michael F Waters Department of Emerg.ncy Medicine University of Florida Gainesville USA Department of Neurolog. University of Florida Gainesville USA Department of Neuroradiolog. University of Florida Gainesville USA Department of Neurosciences University of Florida Gainesville USA. Department of Neurosurg.ry University of Florida Gainesville USA

Backg.ound: The mortality due to mechanical thrombectomy (MT) in the acute treatment of intracranial arterial occlu- sions can be up to 45%. The SWIFT (Solitaire FR with the Intention for Thrombectomy) and Multi MERCI (mechani- cal embolus removal in cerebral ischemia) trials have evaluated the safety and efficacy of MT. It may be important to determine pre-procedural factors that help predict post-intervention prog.osis. We soug.t to determine if admission medical research council (MRC) motor streng.h g.ade along.with other factors can be used as predictor of mortality after MT for acute ischemic stroke. Methods: Retrospective analysis of stroke database assessing.outcomes in all 62 patients who underwent MT as an intervention for acute ischemic stroke, with or without concurrent intravenous thrombolysis was done. Five baseline variables were included in univariate and multivariate analyses to define the in- dependent predictors of mortality during.current hospitalization. The medical research council (MRC) motor g.ade (0 - 5);modified collateral flow (CS) g.ading.(0 - 3);ag.;acute and chronic co-morbidities were used as the baseline vari- ables. If motor streng.h g.ade were different in upper and lower extremities, then the lower g.ade was used. Ag. was analyzed independently as well as dichotomized using.80 as cut-off value. Relevant stroke related acute and chronic co-morbidities were g.ven 1 point each and mean calculated. Results: In the univariate analysis, low (0 - 1) motor streng.h g.ade (OR, 0.11;95% CI, 0.021 - 0.33;p = 0.001) and ag. (OR, 1.06;95% CI, 1.02 - 1.12;p = 0.011) was sig. nificantly associated with mortality. The presence of collateral flow, acute and chronic co-morbidities were not sig.ifi- cantly associated with mortality. In the multivariate analysis, motor g.ade retained its statistical sig.ificance for morta- lity (OR, 0.09;95% CI, 0.01 - 0.32;p = 0.003) along.with chronic co-morbidity (OR, 1.52;95% CI 1.05 - 2.43;

关键词： Motor g.ade Collaterals Ischemic Stroke Endovascular Intervention Outcome after Stroke Mortality after Stroke Acute Stroke Endovascular Treatment Mechanical Thrombectomy

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