Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial
Objectives This work aimed to analyse the risk factors for poor outcomes and mortality among patients with anterior large vessel occlusion (LVO) ischaemic stroke, despite successful recanalisation.Setting and participants This study conducted a secondary analysis among patients who underwent success...
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e078917.full |
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| author | Yong Zhang Jiang Li Peng Liu Wei Wu Pengfei Yang Ya Peng Wenhuo Chen Yujie Sun Tonghui Liu Guangwen Li Bin Zhou Yu Geng Yun Xu Ming Wang Zibo Wang Xiaoxiang Peng Liyong Zhang Jianfeng Chu Congguo Yin Dong Kuai Yaping Xiao Minghua Li Xianjun Zhang Naidong Wang |
| author_facet | Yong Zhang Jiang Li Peng Liu Wei Wu Pengfei Yang Ya Peng Wenhuo Chen Yujie Sun Tonghui Liu Guangwen Li Bin Zhou Yu Geng Yun Xu Ming Wang Zibo Wang Xiaoxiang Peng Liyong Zhang Jianfeng Chu Congguo Yin Dong Kuai Yaping Xiao Minghua Li Xianjun Zhang Naidong Wang |
| author_sort | Yong Zhang |
| collection | DOAJ |
| description | Objectives This work aimed to analyse the risk factors for poor outcomes and mortality among patients with anterior large vessel occlusion (LVO) ischaemic stroke, despite successful recanalisation.Setting and participants This study conducted a secondary analysis among patients who underwent successful recanalisation in the CAPTURE trial. The trial took place between March 2018 and September 2020 at 21 sites in China. The CAPTURE trial enrolled patients who had an acute ischaemic stroke aged 18–80 years with LVO in anterior circulation.Interventions Thrombectomy was immediately performed using Neurohawk or the Solitaire FR after randomisation in CAPTURE trial. Rescue treatment was available for patients with severe residual stenosis caused by atherosclerosis.Primary and secondary outcome measures The primary goal was to predict poor 90-day survival or mortality within 90 days post-thrombectomy. Univariate analysis, using the χ2 test or Fisher’s exact test, was conducted for each selected factor. Subsequently, a multivariable analysis was performed on significant factors (p≤0.10) identified through univariate analysis using the backward selection logistic regression approach.Results Among the 207 recruited patients, 79 (38.2%) exhibited poor clinical outcomes, and 26 (12.6%) died within 90 days post-thrombectomy. Multivariate analysis revealed that the following factors were significantly associated with poor 90-day survival: age ≥67 years, internal carotid artery (ICA) occlusion (compared with middle cerebral artery (MCA) occlusion), initial National Institutes of Health Stroke Scale (NIHSS) score ≥17 and final modified Thrombolysis in Cerebral Infarction (mTICI) score 2b (compared with mTICI 3). Additionally, the following factors were significantly associated with mortality 90 days post-thrombectomy: initial NIHSS score ≥17, ICA occlusion (compared with MCA occlusion) and recanalisation with more than one pass.Conclusions Age, NIHSS score, occlusion site, mTICI score and the number of passes can be independently used to predict poor 90-day survival or mortality within 90 days post-thrombectomy.Trial registration number NCT04995757. |
| format | Article |
| id | doaj-art-3f193b81885a4e0092384e5fa9e26334 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-3f193b81885a4e0092384e5fa9e263342025-08-20T02:11:18ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-078917Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trialYong Zhang0Jiang Li1Peng Liu2Wei Wu3Pengfei Yang4Ya Peng5Wenhuo Chen6Yujie Sun7Tonghui Liu8Guangwen Li9Bin Zhou10Yu Geng11Yun Xu12Ming Wang13Zibo Wang14Xiaoxiang Peng15Liyong Zhang16Jianfeng Chu17Congguo Yin18Dong Kuai19Yaping Xiao20Minghua Li21Xianjun Zhang22Naidong Wang23Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China3 Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaSchool of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, ChinaDepartment of Neurosurgery, Changzhou First People`s Hospital, Changzhou, Jiangsu, ChinaDepartment of Cerebrovascular disease, Fujian Medical University Union Hospital, Fuzhou, Fujian, ChinaDepartment of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of Medical Imaging, No.215 Hospital of Shaanxi Nuclear Geology, Xianyang, Shaanxi, ChinaDepartment of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Chinaresearch fellowCenter for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, ChinaDepartment of Neurology, Nanjing Gulou Hospital, Nanjing, ChinaPeking University, Beijing, ChinaDepartment of Neurointervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Neurology, The third People’s Hospital of Hubei Province, Wuhan, Hubei, ChinaDepartment of Neurosurgery, Liaocheng People`s Hospital Brain Hospital, Liaocheng, Shandong, ChinaDepartment of Neurology, The First People`s Hospital of Jining City, Jining, ChinaDepartment of Neurology, Hangzhou First People`s Hospital, Hangzhou, Zhejiang, ChinaDepartment of Neurosurgery, Shanxi Provincial Cardiovascular Hospital, Taiyuan, ChinaDepartment of Neurology, Shanghai Oriental Hospital, Shanghai, ChinaInstitute of Diagnostic and Interventional Neuroradiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, ChinaDepartment of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaObjectives This work aimed to analyse the risk factors for poor outcomes and mortality among patients with anterior large vessel occlusion (LVO) ischaemic stroke, despite successful recanalisation.Setting and participants This study conducted a secondary analysis among patients who underwent successful recanalisation in the CAPTURE trial. The trial took place between March 2018 and September 2020 at 21 sites in China. The CAPTURE trial enrolled patients who had an acute ischaemic stroke aged 18–80 years with LVO in anterior circulation.Interventions Thrombectomy was immediately performed using Neurohawk or the Solitaire FR after randomisation in CAPTURE trial. Rescue treatment was available for patients with severe residual stenosis caused by atherosclerosis.Primary and secondary outcome measures The primary goal was to predict poor 90-day survival or mortality within 90 days post-thrombectomy. Univariate analysis, using the χ2 test or Fisher’s exact test, was conducted for each selected factor. Subsequently, a multivariable analysis was performed on significant factors (p≤0.10) identified through univariate analysis using the backward selection logistic regression approach.Results Among the 207 recruited patients, 79 (38.2%) exhibited poor clinical outcomes, and 26 (12.6%) died within 90 days post-thrombectomy. Multivariate analysis revealed that the following factors were significantly associated with poor 90-day survival: age ≥67 years, internal carotid artery (ICA) occlusion (compared with middle cerebral artery (MCA) occlusion), initial National Institutes of Health Stroke Scale (NIHSS) score ≥17 and final modified Thrombolysis in Cerebral Infarction (mTICI) score 2b (compared with mTICI 3). Additionally, the following factors were significantly associated with mortality 90 days post-thrombectomy: initial NIHSS score ≥17, ICA occlusion (compared with MCA occlusion) and recanalisation with more than one pass.Conclusions Age, NIHSS score, occlusion site, mTICI score and the number of passes can be independently used to predict poor 90-day survival or mortality within 90 days post-thrombectomy.Trial registration number NCT04995757.https://bmjopen.bmj.com/content/13/12/e078917.full |
| spellingShingle | Yong Zhang Jiang Li Peng Liu Wei Wu Pengfei Yang Ya Peng Wenhuo Chen Yujie Sun Tonghui Liu Guangwen Li Bin Zhou Yu Geng Yun Xu Ming Wang Zibo Wang Xiaoxiang Peng Liyong Zhang Jianfeng Chu Congguo Yin Dong Kuai Yaping Xiao Minghua Li Xianjun Zhang Naidong Wang Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial BMJ Open |
| title | Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial |
| title_full | Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial |
| title_fullStr | Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial |
| title_full_unstemmed | Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial |
| title_short | Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial |
| title_sort | predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in china a secondary analysis of the capture trial |
| url | https://bmjopen.bmj.com/content/13/12/e078917.full |
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