Effectiveness of Thrombectomy in Stroke According to Baseline Prognostic Factors: Inverse Probability of Treatment Weighting Analysis of a Population-Based Registry

Background and Purpose In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors. Me...

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Published in:Journal of stroke 2021, 23(3), 15, pp.401-410
Main Authors: Rudilosso, Salvatore, Ríos, José, Rodríguez, Alejandro, Gomis, Meritxell, Vera, Víctor, Gómez-Choco, Manuel, Renú, Arturo, Matos, Núria, Llull, Laura, Purroy, Francisco, Amaro, Sergio, Terceño, Mikel, Obach, Víctor, Serena, Joaquim, Martí-Fàbregas, Joan, Cardona, Pedro, Molina, Carlos, Rodríguez-Campello, Ana, Cánovas, David, Krupinski, Jerzy, Ustrell, Xavier, Torres, Ferran, Román, Luis San, Salvat-Plana, Mercè, Jiménez-Fàbrega, Francesc Xavier, Palomeras, Ernest, Catena, Esther, Colom, Carla, Cocho, Dolores, Baiges, Juanjo, Aragones, Josep Maria, Diaz, Gloria, Costa, Xavier, Almendros, María Cruz, Rybyeba, Maria, Barceló, Miquel, Carrión, Dolors, Lòpez, Matilde Núria, Sanjurjo, Eduard, de la Ossa, Natalia Pérez, Urra, Xabier, Chamorro, Ángel
Format: Article
Language:English
Subjects:
Original
outcome
prognosis
propensity score
registries
stroke
thrombectomy
신경과학
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Summary:Background and Purpose In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors. Methods Retrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019. The effect of MT on good functional outcome (modified Rankin Score ≤2) and survival at 3 months was studied using inverse probability of treatment weighting (IPTW) analysis in three pre-defined baseline prognostic groups: poor (if pre-stroke disability, age >85 years, National Institutes of Health Stroke Scale [NIHSS] >25, time from onset >6 hours, Alberta Stroke Program Early CT Score 3), good (if NIHSS
ISSN:2287-6391
2287-6405
DOI:10.5853/jos.2021.00962