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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2305-2308 |
| Number of pages | 4 |
| Journal | Stroke; a journal of cerebral circulation |
| Volume | 46 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2015 |
| Externally published | Yes |
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Keywords
- carotid artery, internal
- intracra
- mortality
- nial hemorrhages
- stroke
- thrombectomy
ASJC Scopus subject areas
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Advanced and Specialized Nursing
Cite this
Predictors of Mortality in Acute Ischemic Stroke Intervention : Analysis of the North American Solitaire Acute Stroke Registry. / Linfante, Italo; Walker, Gail R.; Castonguay, Alicia C.; Dabus, Guilherme; Starosciak, Amy K.; Yoo, Albert J.; Abou-Chebl, Alex; Britz, Gavin W.; Marden, Franklin A.; Alvarez, Alexandria; Gupta, Rishi; Sun, Chun Huan J.; Martin, Coleman; Holloway, William E.; Mueller-Kronast, Nils; English, Joey D.; Malisch, Tim W.; Bozorgchami, Hormozd; Xavier, Andrew; Rai, Ansaar T.; Froehler, Michael T.; Badruddin, Aamir; Nguyen, Thanh N.; Taqi, M. Asif; Abraham, Michael G.; Janardhan, Vallabh; Shaltoni, Hashem; Novakovic, Roberta; Chen, Peng R.; Kaushal, Ritesh; Nanda, Ashish; Issa, Mohammad A.; Nogueira, Raul G.; Zaidat, Osama O.
In: Stroke; a journal of cerebral circulation, Vol. 46, No. 8, 01.08.2015, p. 2305-2308.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictors of Mortality in Acute Ischemic Stroke Intervention
T2 - Analysis of the North American Solitaire Acute Stroke Registry
AU - Linfante, Italo
AU - Walker, Gail R.
AU - Castonguay, Alicia C.
AU - Dabus, Guilherme
AU - Starosciak, Amy K.
AU - Yoo, Albert J.
AU - Abou-Chebl, Alex
AU - Britz, Gavin W.
AU - Marden, Franklin A.
AU - Alvarez, Alexandria
AU - Gupta, Rishi
AU - Sun, Chun Huan J.
AU - Martin, Coleman
AU - Holloway, William E.
AU - Mueller-Kronast, Nils
AU - English, Joey D.
AU - Malisch, Tim W.
AU - Bozorgchami, Hormozd
AU - Xavier, Andrew
AU - Rai, Ansaar T.
AU - Froehler, Michael T.
AU - Badruddin, Aamir
AU - Nguyen, Thanh N.
AU - Taqi, M. Asif
AU - Abraham, Michael G.
AU - Janardhan, Vallabh
AU - Shaltoni, Hashem
AU - Novakovic, Roberta
AU - Chen, Peng R.
AU - Kaushal, Ritesh
AU - Nanda, Ashish
AU - Issa, Mohammad A.
AU - Nogueira, Raul G.
AU - Zaidat, Osama O.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - 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.
AB - 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.
KW - carotid artery, internal
KW - intracra
KW - mortality
KW - nial hemorrhages
KW - stroke
KW - thrombectomy
UR - http://www.scopus.com/inward/record.url?scp=84944672621&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84944672621&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.115.009530
DO - 10.1161/STROKEAHA.115.009530
M3 - Article
VL - 46
SP - 2305
EP - 2308
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 8
ER -