Evidence map›Paper›PMID 32865630›Full record

ArticleJournal of neurology2021

Impact of pre-stroke dependency on outcome after endovascular therapy in acute ischemic stroke.

Lisa Oesch, Marcel Arnold, Corrado Bernasconi, Johannes Kaesmacher, Urs Fischer, Pascal J Mosimann, Simon Jung, Thomas Meinel, Martina Goeldlin, Mirjam Heldner and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 2 countries.

Lisa OeschDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Marcel ArnoldDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Corrado BernasconiDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Johannes KaesmacherDepartment of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Urs FischerDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Pascal J MosimannDepartment of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Simon JungDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Thomas MeinelDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Martina GoeldlinDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Mirjam HeldnerDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Bastian VolbersDepartment of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Jan Gralla *Department of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland.
Hakan Sarikaya *Department of Neurology, Bern University Hospital, Freiburgstrasse 10, 3010, Bern, Switzerland. hakan.sarikaya@insel.ch.
University Hospital of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeCurrent demographic changes indicate that more people will be care-dependent due to increasing life expectancy. Little is known about impact of preexisting dependency on stroke outcome after endovascular treatment (EVT).

methodsWe compared prospectively collected baseline and outcome data of previously dependent vs. independent stroke patients (prestroke modified Rankin Scale score of 3-5 vs. 0-2) treated with EVT. Outcome measures were favorable 3-month outcome (mRS ≤ 3 for previously dependent and mRS ≤ 2 for independent patients, respectively), death and symptomatic intracranial hemorrhage (sICH).

resultsAmong 1247 patients, 84 (6.7%) were dependent before stroke. They were older (81 vs. 72 years of age), more often female (61.9% vs. 46%), had a higher stroke severity at baseline (NIHSS 18 vs. 15 points), more often history of previous stroke (32.9% vs. 9.1%) and more vascular risk factors than independent patients. Favorable outcome and mortality were to the disadvantage of independent patients (26.2% vs. 44.4% and 46.4% vs. 25.5%, respectively), whereas sICH was comparable in both cohorts (4.9% vs. 5%). However, preexisting dependency was not associated with clinical outcome and mortality after adjusting for outcome predictors (OR 1.076, 95% CI 0.612-1.891; p = 0.799 and OR 1.267, 95% CI 0.758-2.119; p = 0.367, respectively).

conclusionOur study underscores the need for careful selection of care-dependent stroke patients when considering EVT, given a less favorable outcome observed in this cohort. Nonetheless, EVT should not systematically be withheld in patients with preexisting disability, since prior dependency does not significantly influence outcome.

Indexed as

Brain IschemiaEndovascular ProceduresIschemic StrokeStrokeFemaleHumansTreatment OutcomeDependencyDisabilityEndovascular treatmentIschemic strokeOutcome

Identifiers

PMID32865630
PMCPMC7880932
OpenAlexW3082362635

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.