Associations between basic physiological observations recorded pre-thrombectomy and functional outcome: a systematic...

Area of Science:

• Neurology
• Cardiology
• Emergency Medicine

Background:

• Mechanical thrombectomy improves outcomes for acute large vessel occlusion (LVO) stroke.
• Predictors of thrombectomy success include clinical factors and baseline physiological observations.
• Routine emergency assessment data may inform triage decisions if linked to post-thrombectomy outcomes.

Purpose of the Study:

• To conduct a meta-analysis of pre-thrombectomy physiological observations and functional outcomes.
• To identify routinely available clinical data that predict mechanical thrombectomy success.

Main Methods:

• Meta-analysis following PRISMA guidelines.
• Searched Medline, PubMed, Cochrane HTA, Cochrane Central, and Embase for relevant studies (2004-2023).
• Assessed risk of bias using the Quality in Prognostic Studies (QUIPS) tool and analyzed data using RevMan 5.

Main Results:

• Higher blood glucose (continuous and categorical), higher systolic blood pressure (SBP), and atrial fibrillation were associated with unfavorable outcomes.
• Lower Glasgow Coma Scale scores also correlated with unfavorable outcomes.
• No significant association was found between diastolic blood pressure (DBP) and outcome.

Conclusions:

• Basic physiological observations can aid in early triage for thrombectomy patients.
• These predictors may help avoid futile treatments and unnecessary transfers.
• Further research is needed to establish optimal prognostic factor combinations for clinical decision-making.