Predictive factors of poor outcome and mortality among anterior ischaemic stroke patients despite successful recanalisation in China: a secondary analysis of the CAPTURE trial
Yong Zhang,
Jiang Li,
Peng Liu,
Wei Wu,
Pengfei Yang,
Ya Peng,
Wenhuo Chen,
Yujie Sun,
Tonghui Liu,
Guangwen Li,
Bin Zhou,
Yu Geng,
Yun Xu,
Ming Wang,
Zibo Wang,
Xiaoxiang Peng,
Liyong Zhang,
Jianfeng Chu,
Congguo Yin,
Dong Kuai,
Yaping Xiao,
Minghua Li,
Xianjun Zhang,
Naidong Wang
Affiliations
Yong Zhang
Department of Paediatrics, Sichuan Provincial Hospital for Women and Children, Chengdu, Sichuan, China
Jiang Li
Department of Neurosurgery, The Second Affiliated Hospital of Air Force Military Medical University, Xi`an, China
Peng Liu
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
Wei Wu
Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
Pengfei Yang
Neurovascular Center, Changhai Hospital, Naval Military Medical University, Shanghai, China
Ya Peng
12 Department of Neurosurgery, Changzhou No. 1 People`s Hospital, Changzhou, China
Wenhuo Chen
8 Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
Yujie Sun
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
Tonghui Liu
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
Guangwen Li
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
Bin Zhou
Department of Neurointervention, Cerebrovascular Disease Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
Yu Geng
Department of Neurology, Zhejiang Provincial People`s Hospital, Hangzhou, Zhejiang, China
Yun Xu
Department of Neurology, Nanjing Gulou Hospital, Nanjing, China
Ming Wang
Department of Neurointervention, Nanyang Second People`s Hospital, Nanyang, China
Zibo Wang
Department of Neurointervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
Xiaoxiang Peng
Department of Neurology, The Third People`s Hospital of Hubei Province, Wuhan, China
Liyong Zhang
Department of Neurosurgery, Liaocheng People`s Hospital Brain Hospital, Liaocheng, Shandong, China
Jianfeng Chu
Department of Neurology, The First People`s Hospital of Jining City, Jining, China
Congguo Yin
Department of Neurology, Hangzhou First People`s Hospital, Hangzhou, Zhejiang, China
Dong Kuai
Department of Neurosurgery, Shanxi Provincial Cardiovascular Hospital, Taiyuan, China
Yaping Xiao
Department of Neurology, Shanghai Oriental Hospital, Shanghai, China
Minghua Li
Institute of Diagnostic and Interventional Neuroradiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
Xianjun Zhang
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
Naidong Wang
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
Objectives This work aimed to analyse the risk factors for poor outcomes and mortality among patients with anterior large vessel occlusion (LVO) ischaemic stroke, despite successful recanalisation.Setting and participants This study conducted a secondary analysis among patients who underwent successful recanalisation in the CAPTURE trial. The trial took place between March 2018 and September 2020 at 21 sites in China. The CAPTURE trial enrolled patients who had an acute ischaemic stroke aged 18–80 years with LVO in anterior circulation.Interventions Thrombectomy was immediately performed using Neurohawk or the Solitaire FR after randomisation in CAPTURE trial. Rescue treatment was available for patients with severe residual stenosis caused by atherosclerosis.Primary and secondary outcome measures The primary goal was to predict poor 90-day survival or mortality within 90 days post-thrombectomy. Univariate analysis, using the χ2 test or Fisher’s exact test, was conducted for each selected factor. Subsequently, a multivariable analysis was performed on significant factors (p≤0.10) identified through univariate analysis using the backward selection logistic regression approach.Results Among the 207 recruited patients, 79 (38.2%) exhibited poor clinical outcomes, and 26 (12.6%) died within 90 days post-thrombectomy. Multivariate analysis revealed that the following factors were significantly associated with poor 90-day survival: age ≥67 years, internal carotid artery (ICA) occlusion (compared with middle cerebral artery (MCA) occlusion), initial National Institutes of Health Stroke Scale (NIHSS) score ≥17 and final modified Thrombolysis in Cerebral Infarction (mTICI) score 2b (compared with mTICI 3). Additionally, the following factors were significantly associated with mortality 90 days post-thrombectomy: initial NIHSS score ≥17, ICA occlusion (compared with MCA occlusion) and recanalisation with more than one pass.Conclusions Age, NIHSS score, occlusion site, mTICI score and the number of passes can be independently used to predict poor 90-day survival or mortality within 90 days post-thrombectomy.Trial registration number NCT04995757.
