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dc.contributorDepartament de Salut
dc.contributor.authorRudilosso, S
dc.contributor.authorRíos, José
dc.contributor.authorRodríguez, Alejandro
dc.contributor.authorGomis, Meritxell
dc.contributor.authorVera, Víctor
dc.contributor.authorGomez-Choco, Manuel
dc.contributor.authorMolina Cateriano, Carlos
dc.contributor.authorCocho, Dolores
dc.date.accessioned2022-02-22T12:37:14Z
dc.date.available2022-02-22T12:37:14Z
dc.date.issued2021-09-30
dc.identifier.citationRudilosso S, Ríos J, Rodríguez A, Gomis M, Vera V, Gómez-Choco M, et al. Effectiveness of Thrombectomy in Stroke According to Baseline Prognostic Factors: Inverse Probability of Treatment Weighting Analysis of a Population-Based Registry. J Stroke. 2021 Sep;23(3):401-410.
dc.identifier.issn2287-6391
dc.identifier.urihttp://hdl.handle.net/11351/7070
dc.descriptionStroke; Thrombectomy; Prognosis
dc.description.abstractBackground 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 <6, proximal vertebrobasilar occlusion, supratherapeutic international normalized ratio >3), good (if NIHSS <6 or distal occlusion, in the absence of poor prognostic factors), or reference (not meeting other groups' criteria). Results: Patients receiving MT (n=1,996, 77%) were younger, had less pre-stroke disability, and received systemic thrombolysis less frequently. These differences were balanced after the IPTW stratified by prognosis. MT was associated with good functional outcome in the reference (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.0 to 4.4), and especially in the poor baseline prognostic stratum (OR, 3.9; 95% CI, 2.6 to 5.9), but not in the good prognostic stratum. MT was associated with survival only in the poor prognostic stratum (OR, 2.6; 95% CI, 2.0 to 3.3). Conclusions: Despite their worse overall outcomes, the impact of thrombectomy over medical management was more substantial in patients with poorer baseline prognostic factors than patients with good prognostic factors.
dc.language.isoeng
dc.publisherKorean Stroke Society
dc.relation.ispartofseriesJournal of stroke;23(3)
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.sourceScientia
dc.subjectSang - Coagulació - Trastorns
dc.subjectIsquèmia cerebral
dc.subjectMalalties cerebrovasculars - Prognosi
dc.subject.meshThrombectomy
dc.subject.meshBrain Ischemia
dc.subject.meshPrognosis
dc.titleEffectiveness of Thrombectomy in Stroke According to Baseline Prognostic Factors: Inverse Probability of Treatment Weighting Analysis of a Population-Based Registry
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.5853/jos.2021.00962
dc.subject.decstrombectomía
dc.subject.decsisquemia cerebral
dc.subject.decspronóstico
dc.relation.publishversionhttps://doi.org/10.5853/jos.2021.00962
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.authoraffiliation[Rudilosso S] Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain. Clinical and Experimental Neuroscience: Cerebrovascular Diseases, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain. [Ríos J] Medical Statistics Core Facility, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Hospital Clinic, Barcelona, Spain. Biostatistics Unit, Faculty of Medicine, Autonomous University of Barcelona, Barcelona, Spain. [Rodríguez A, Vera V] Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain. [Gomis M] Stroke Unit, Department of Neuroscience, Germans Trias Hospital, Badalona, Spain. [Gómez-Choco M] Department of Neurology, Moisès-Broggi Hospital, Sant Joan Despí, Spain. [Molina C] Unitat d’Ictus, Servei de Neurologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Cocho D] Department of Emergency, Hospital General de Granollers, Granollers, Spain
dc.identifier.pmid34649384
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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