Highlights
- •Thrombectomy has not been proven to reduce mortality in stroke patients.
- •Age, NIHSS score, and successful revascularization were predictors of mortality.
- •Further efforts to identify modifiable risk factors of mortality are warranted.
Abstract
Objective
The aims of this single-center, retrospective cohort study are to assess the outcomes
of endovascular mechanical thrombectomy (EMT) for acute ischemic stroke (AIS) and
determine predictors of 30-day mortality at an academic comprehensive stroke center
(CSC).
Methods
We retrospectively collected data from consecutive patients who underwent EMT for
AIS at our institution between April 2016 and January 2018. Primary outcome was defined
as mortality within 30 days from EMT. Successful revascularization was defined as
a modified Thrombolysis in Cerebral Infarction (mTICI) grade 2b-3. Statistical analyses
were performed to identify predictors of 30-day mortality.
Results
The study cohort was comprised 57 patients (51% male) with mean age of 72 years. Intravenous
tissue plasminogen activator was administered in 51%. The median Alberta Stroke Program
Early Computed Tomography Score (ASPECTS) and National Institutes of Health Stroke
Scale (NIHSS) score were 8 and 20, respectively. The 30-day mortality rate was 39%.
Univariate analyses found that older age (mean 77 vs. 68 years, p = 0.022), higher
baseline NIHSS score (median 23 vs. 19, p = 0.032), NIHSS score at 24 h after EMT
(median 14.5 vs. 7.5, p < 0.001), and lower rates of successful revascularization
(59% vs. 89%, p = 0.021) were associated with 30-day mortality.
Conclusion
We observed a moderate rate of 30-day mortality after EMT at an academic CSC. Older
age, higher baseline NIHSS score, higher NIHSS score at 24 h after thrombectomy, and
lower rates of successful revascularization were predictive of 30-day mortality in
univariate analysis. Further efforts to identify modifiable risk factors of mortality
are warranted.
Keywords
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Article info
Publication history
Published online: August 22, 2018
Accepted:
August 13,
2018
Received:
April 28,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
