Quality of life after endovascular thrombectomy: A multicenter, prospective, observational study

Patient-reported, health-related quality of life (QOL) metrics that capture elements not always accounted for by traditional scales are increasingly recognized as important measures but are still under-utilized. We studied QOL in a recent cohort of endovascular thrombectomy (EVT) patients.

We conducted a multicenter, prospective, observational study of patients treated with EVT. The primary and secondary outcome measures were 90-day EuroQol 5-Dimension 5-Level index (EQ index, scores -0.573 to 1) and the Visual Analog Scale (VAS, 0-100), respectively. Spearman correlation was used to assess correlations between the EQ index and VAS with the 90-day modified Rankin Scale (mRS) and between each EuroQol domain and 90-day mRS. Linear regression was performed to identify factors associated with the outcomes.

212 subjects (mean age 68.4 ± 14.7 years, median NIHSS 15 [interquartile range 10-20]) were included. Mean EQ index was 0.45 ± 0.42 and median VAS was 75 (interquartile range 60-90). Over 40% of subjects reported at slight problems or worse in each QOL domain and nearly 80% reported such problems in at least one domain. EQ index and 90-day mRS were strongly correlated in the full cohort (r_s= -0.912, p<0.001) and in survivors (r_s= -0.709, p<0.001). In the multiple linear regression analyses, premorbid mRS, cerebral blood volume index, and length of stay appeared to be associated with EQ index and VAS.

Ninety-day QOL measures may provide useful information as an adjunct to mRS scoring in selected stroke thrombectomy patients.