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Updated: Aug 14, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Predictors of functional dependence at one year in acute ischemic stroke with large vessel occlusion
Liu-Zhu Chen1, Yu-Jie Tu1, Ye-Zhi Huang1
1Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Insights
Predictors of one-year functional outcomes in emergent large vessel occlusion (eLVO) stroke patients were identified. Old age, low ASPECTS, and complications like pneumonia predict dependence, while male sex and rehabilitation improve outcomes.
Area of Science:
- Neuroscience
- Clinical Neurology
- Public Health
Background:
- The clinical management and long-term prognosis of emergent large vessel occlusion (eLVO) strokes in China remain incompletely understood.
- Identifying factors influencing patient recovery is crucial for improving stroke care.
Purpose of the Study:
- To investigate predictors of one-year functional outcomes in patients experiencing acute ischemic stroke due to eLVO.
- To identify factors associated with delayed functional independence (DFI) in this patient cohort.
Main Methods:
- Retrospective analysis of 536 patients treated for eLVO.
- Logistic regression used to identify significant predictors of one-year functional outcomes and DFI.
- One-year follow-up data collected from surviving patients.
Main Results:
- Old age, low Alberta Stroke Program Early CT Score (ASPECTS), unsuccessful reperfusion, poor medication adherence, and stroke-associated pneumonia (SAP) predicted functional dependence at one year.
- Male sex, good medication adherence, and attending rehabilitation centers were independent predictors of delayed functional independence (DFI).
Conclusions:
- Key factors influencing one-year functional outcomes in eLVO patients include age, stroke severity (ASPECTS), reperfusion success, medication adherence, and complications like SAP.
- Positive predictors for DFI include male sex, adherence to medication, and engagement with rehabilitation services.
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.
