Predictors of functional dependence at one year in acute ischemic stroke with large vessel occlusion

Article type: Research Article

Authors: Chen, Liu-Zhu^a | Tu, Yu-Jie^a | Huang, Ye-Zhi^a | Qiu, Li-Nan^a | Chen, Jia-Hao^a | Xu, Xue-Qian^a | Xu, Min-Jie^b | Geng, Dan-Dan^b | Lin, Yi-Si^a | He, Jin-Cai^{a; *}

Affiliations: [a] Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China | [b] School of Mental Health, Wenzhou Medical University, Wenzhou, China

Correspondence: [*] Address for correspondence: Jin-Cai He, Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China. E-mail: hjc@wmu.edu.cn.

Abstract: BACKGROUND:In China, the current status of clinical treatment of eLVO and the factors affecting its long-term prognosis are unclear. OBJECTIVE:This study aims to explore the predictive factors of functional outcomes at one year in patients of acute ischemic stroke with emergent large vessel occlusion (eLVO). METHODS:We retrospectively collected 536 patients who underwent treatments for eLVO. Primary outcomes included one-year functional outcomes and delayed functional independence (DFI). The logistic regression was performed to predict the primary outcome. RESULTS:431 (85%) survivors participated in the one-year follow-up. In the multivariate logistic analysis adjusted for baseline characteristics, the following factors were found to be significant predictors of functional dependence at one year: old age (aOR = 1.042, 95% CI=1.01-1.076, p = 0.011), low Alberta stroke program early CT score (ASPECTS) (aOR = 0.791, 95% CI=0.671-0.933, p = 0.005), unsuccessful reperfusion (aOR = 0.168, 95% CI=0.048-0.586, p = 0.005), poor medication compliance (aOR = 0.022, 95% CI=0.007-0.072, p < 0.001), and complicated with stroke-associated pneumonia (SAP) (aOR = 2.269, 95% CI=1.103-4.670, p = 0.026). We also found that men (aOR = 3.947, 95% CI=1.15-13.549, p = 0.029) had better medication adherence (aOR = 14.077, 95% CI=1.736-114.157, p = 0.013), and going to rehabilitation centers (aOR = 5.197, 95% CI=1.474-18.327, p = 0.010) were independent predictors of DFI. CONCLUSION:The significant predictors of functional dependence at one year were: old age, low ASPECTS, unsuccessful reperfusion, poor medication adherence, and combination with SAP. Men, good medication adherence, and going to rehabilitation centers contributed to getting delayed functional independence.

Keywords: Stroke, large vessel occlusion, endovascular therapy, thrombolysis, prognosis

DOI: 10.3233/NRE-220269

Journal: NeuroRehabilitation, vol. 52, no. 2, pp. 187-197, 2023