Cited 9 times in

Clinical outcome of patients with mild pre-stroke morbidity following endovascular treatment: a HERMES substudy

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dc.contributor.author허지회-
dc.date.accessioned2024-07-01T06:50:59Z-
dc.date.available2024-07-01T06:50:59Z-
dc.date.issued2023-03-
dc.identifier.issn1759-8478-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/199831-
dc.description.abstractBackground: Analyses of the effect of pre-stroke functional levels on the outcome of endovascular therapy (EVT) have focused on the course of patients with moderate to substantial pre-stroke disability. The effect of complete freedom from pre-existing disability (modified Rankin Scale (mRS) 0) versus predominantly mild pre-existing disability/symptoms (mRS 1-2) has not been well delineated. Methods: The HERMES meta-analysis pooled data from seven randomized trials that tested the efficacy of EVT. We tested for a multiplicative interaction effect of pre-stroke mRS on the relationship between treatment and outcomes. Ordinal regression was used to assess the association between EVT and 90-day mRS (primary outcome) in the subgroup of patients with pre-stroke mRS 1-2. Multivariable regression modeling was then used to test the effect of mild pre-stroke disability/symptoms on the primary and secondary outcomes (delta-mRS, mRS 0-2/5-6) compared with patients with pre-stroke mRS 0. Results: We included 1764 patients, of whom 199 (11.3%) had pre-stroke mRS 1-2. No interaction effect of pre-stroke mRS on the relationship between treatment and outcome was observed. Patients with pre-stroke mRS 1-2 had worse outcomes than those with pre-stroke mRS 0 (adjusted common OR (acOR) 0.53, 95% CI 0.40 to 0.70). Nonetheless, a significant benefit of EVT was observed within the mRS 1-2 subgroup (cOR 2.08, 95% CI 1.22 to 3.55). Conclusions: Patients asymptomatic/without disability prior to onset have better outcomes following EVT than patients with mild disability/symptoms. Patients with pre-stroke mRS 1-2, however, more often achieve good outcomes with EVT compared with conservative management. These findings indicate that mild pre-existing disability/symptoms influence patient prognosis after EVT but do not diminish the EVT treatment effect.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherBMJ Publishing Group-
dc.relation.isPartOfJOURNAL OF NEUROINTERVENTIONAL SURGERY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHBrain Ischemia* / therapy-
dc.subject.MESHEndovascular Procedures* / adverse effects-
dc.subject.MESHHumans-
dc.subject.MESHStroke* / etiology-
dc.subject.MESHStroke* / surgery-
dc.subject.MESHThrombectomy / adverse effects-
dc.subject.MESHTreatment Outcome-
dc.titleClinical outcome of patients with mild pre-stroke morbidity following endovascular treatment: a HERMES substudy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Neurology (신경과학교실)-
dc.contributor.googleauthorRosalie V McDonough-
dc.contributor.googleauthorJohanna M Ospel-
dc.contributor.googleauthorCharles B L M Majoie-
dc.contributor.googleauthorJeffrey L Saver-
dc.contributor.googleauthorPhilip White-
dc.contributor.googleauthorDiederik W J Dippel-
dc.contributor.googleauthorScott B Brown-
dc.contributor.googleauthorAndrew M Demchuk-
dc.contributor.googleauthorTudor G Jovin-
dc.contributor.googleauthorPeter J Mitchell-
dc.contributor.googleauthorSerge Bracard-
dc.contributor.googleauthorBruce C V Campbell-
dc.contributor.googleauthorKeith W Muir-
dc.contributor.googleauthorMichael D Hill-
dc.contributor.googleauthorFrancis Guillemin-
dc.contributor.googleauthorMayank Goyal-
dc.contributor.googleauthorHERMES collaborators-
dc.identifier.doi10.1136/neurintsurg-2021-018428-
dc.contributor.localIdA04369-
dc.relation.journalcodeJ02880-
dc.identifier.eissn1759-8486-
dc.identifier.pmid35210331-
dc.identifier.urlhttps://jnis.bmj.com/content/15/3/214.long-
dc.subject.keywordstroke-
dc.subject.keywordthrombectomy-
dc.contributor.alternativeNameHeo, Ji Hoe-
dc.contributor.affiliatedAuthor허지회-
dc.citation.volume15-
dc.citation.number3-
dc.citation.startPage214-
dc.citation.endPage220-
dc.identifier.bibliographicCitationJOURNAL OF NEUROINTERVENTIONAL SURGERY, Vol.15(3) : 214-220, 2023-03-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers

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