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Published on: August 11, 2023
Outcome predictors in acute basilar artery occlusion
Insights
Predictors of good outcome in acute basilar artery occlusion (BAO) include younger age, absence of diabetes mellitus, and less severe stroke. These factors are crucial for improving patient prognosis in BAO cases.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Stroke Research
Background:
- Acute basilar artery occlusion (BAO) frequently leads to severe neurological deficits and high mortality.
- Understanding predictors of good outcome is essential for optimizing treatment strategies.
Purpose of the Study:
- To identify independent predictors of favorable outcomes in patients with acute basilar artery occlusion.
- To analyze factors influencing recovery and long-term prognosis after BAO.
Main Methods:
- A cohort of 70 acute ischemic stroke patients with BAO was analyzed.
- Factors assessed included baseline characteristics, risk factors, treatment details, and neurological status.
- Outcomes were evaluated using the modified Rankin Scale at 30 and 90 days, with good outcome defined as a score of 0-3.
Main Results:
- Statistically significant differences were observed in age, arterial hypertension, diabetes mellitus, stroke severity, and neurological deficit between good and poor outcome groups.
- Successful recanalization and greater improvement in neurological deficit were associated with better outcomes.
- Logistic regression identified older age, diabetes mellitus, and severe stroke as independent negative predictors of good outcome.
Conclusions:
- Older age, presence of diabetes mellitus, and severe stroke are significant independent predictors of poor outcome in acute basilar artery occlusion.
- These findings highlight key factors to consider in managing BAO patients to improve prognoses.
Objective:
to identify predictors of good outcome in acute basilar artery occlusion (Bao). Background: acute ischemic stroke (aiS) caused by Bao is often associated with a severe and persistent neurological deficit and a high mortality rate.
Methods:
the set consisted of 70 consecutive aiS patients (51 males; mean age 64.5 ± 14.5 years) with Bao. the role of the following factors was assessed: baseline characteristics, stroke risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, estimated time to therapy procedure initiation, treatment method, recanalization rate, change in neurological deficit, post-treatment imaging findings. 30- and 90-day outcome was assessed using the modified rankin scale with a good outcome defined as a score of 0– 3.
Results:
the following statistically significant differences were found between patients with good versus poor outcomes: mean age (54.2 vs. 68.9 years; p=0.0001), presence of arterial hypertension (52.4% vs. 83.7%; p=0.015), diabetes mellitus (9.5% vs. 55.1%; p=0.0004) and severe stroke (14.3% vs. 65.3%; p=0.0002), neurological deficit at time of treatment (14.0 vs. 24.0 median of national institutes of health Stroke Scale [nihSS] points; p=0.001), successful recanalization (90.0% vs. 54.2%; p=0.005), change in neurological deficit (12.0 vs. 1.0 median difference of nihSS points; p=0.005). Stepwise binary logistic regression analysis identified age (or=0.932, 95% Ci=0.882–0.984; p=0.012), presence of diabetes mellitus (or=0.105, 95% Ci=0.018-0.618; p=0.013) and severe stroke (or=0.071, 95% Ci=0.013-0.383; p=0.002) as significant independent negative predictors of good outcome.
Conclusions:
in the present study, higher age, presence of diabetes mellitus and severe stroke were identified as significant independent negative predictors of good outcome.
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