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Published on: July 31, 2014
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Mortality After Total Anterior Circulation Stroke: A 25-Year Observational Study
J Oliver Neal1, Sherry Hu2, John Reid3
1Dalhousie Department of Medicine, Division of Neurology, 1796 Summer St., Halifax, NS, Canada.
Summary
Mortality after Total Anterior Circulation Stroke (TACS) decreased with alteplase and endovascular thrombectomy (EVT). These recanalization therapies improve outcomes for acute ischemic stroke patients.
Area of Science:
- Neurology
- Cardiovascular Diseases
- Public Health
Background:
- Acute ischemic stroke, particularly Total Anterior Circulation Stroke (TACS), has high mortality rates despite treatment advances.
- TACS patients, often with middle cerebral artery occlusions, show significant benefit from therapies like endovascular thrombectomy (EVT).
Purpose of the Study:
- To investigate temporal trends in 30-day in-hospital mortality after TACS.
- To identify factors associated with mortality and functional outcomes in TACS patients.
Main Methods:
- Analysis of 1106 community-onset TACS patients from a prospective registry (1994-2019).
- Multivariate analysis of 30-day in-hospital mortality and functional outcomes.
Main Results:
- 30-day in-hospital mortality (41%) initially rose then fell over 25 years.
- Increased mortality linked to age and stroke severity; decreased mortality linked to alteplase, EVT, and early presentation (<12 hours).
- Alteplase, EVT, or both improved functional independence, discharge home, and reduced hospital stay.
Conclusions:
- Recanalization therapies (alteplase, EVT) significantly reduce 30-day mortality in TACS.
- Observational data confirm the clinical benefits of recanalization therapies for acute ischemic stroke.
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