Predictors of home discharge after mechanical thrombectomy in patients with acute ischemic stroke: Usefulness of National Institutes of Health Stroke Scale sub-items assessed 24 h postoperatively

Abstract

Objective: The purpose of this study was to clarify whether patients with acute cerebral infarction who underwent mechanical thrombectomy (MT) can be discharged to their homes based on the National Institutes of Health Stroke Scale (NIHSS) sub-items at 24 h postoperatively. Methods: We screened 111 patients with acute ischemic stroke hospitalized and treated with MT in the Department of Neurology of Hospital A between April 2014 and December 2018. The survey items were the personal attributes, medical findings, NIHSS sub-items assessed 24 h postoperatively. Logistic regression was used to identify predictors of outcome. Results: This study included 94 (32 and 62 were discharged home and to other hospitals, respectively). In multiple logistic regression analysis, significant associations for the discharge outcome were found for the following items: questions (odds ratio: 4.61, 95% confidence interval: 1.215–17.485), facial nerve paralysis (odds ratio, 4.33; 95% confidence interval, 1.178–15.953), paralyzed upper-limb movement (odds ratio: 7.92, 95% confidence interval: 2.188–28.702), and erase phenomenon/attention disorder (odds ratio, 5.19; 95% confidence interval, 14.026–19.224) . Conclusions: Among the NIHSS sub-items, questions, facial nerve paralysis, paralyzed upper-limb movement, and erase phenomenon/attention disorder assessed 24 h postoperatively could be expected to predict early home discharge in patients.

Keywords

• Acute
• Infarction
• Mechanical thrombectomy
• NIHSS sub-items
• Outcome
• Retrospective study