Evidence map›Paper›PMID 34649384›Full record

ArticleJournal of stroke2021

Effectiveness of Thrombectomy in Stroke According to Baseline Prognostic Factors: Inverse Probability of Treatment Weighting Analysis of a Population-Based Registry.

Salvatore Rudilosso, José Ríos, Alejandro Rodríguez, Meritxell Gomis, Víctor Vera, Manuel Gómez-Choco, Arturo Renú, Núria Matos, Laura Llull, Francisco Purroy and 33 more

Abstract read
In one paragraph

Article in Journal of stroke, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

43 authors.

Salvatore RudilossoComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
José RíosMedical Statistics Core Facility, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Hospital Clinic, Barcelona, Spain.
Alejandro RodríguezComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
Meritxell GomisStroke Unit, Department of Neuroscience, Germans Trias Hospital, Badalona, Spain.
Víctor VeraComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
Manuel Gómez-ChocoDepartment of Neurology, Moisès-Broggi Hospital, Sant Joan Despí, Spain.
Arturo RenúComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
Núria MatosDepartment of Neurology, Althaia Foundation Hospital, Manresa, Spain.
Laura LlullComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
Francisco PurroyStroke Unit, Department of Neurology, University Hospital Arnau of Vilanova, Lleida, Spain.
Sergio AmaroComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
Mikel TerceñoStroke Unit, Department of Neurology, Josep Trueta University Hospital, Girona, Spain.
Víctor ObachComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
Joaquim SerenaStroke Unit, Department of Neurology, Josep Trueta University Hospital, Girona, Spain.
Joan Martí-FàbregasStroke Unit, Department of Neurology, Santa Creu i Sant Pau, Barcelona, Spain.
Pedro CardonaStroke Unit, Department of Neurology, Bellvitge University Hospital, Barcelona, Spain.
Carlos MolinaStroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain.
Ana Rodríguez-CampelloStroke Unit, Department of Neurology, Hospital del Mar, Barcelona, Spain.
David CánovasDepartment of Neurology, Parc Taulí Hospital, Sabadell, Spain.
Jerzy KrupinskiDepartment of Neurology, Mutua de Terrassa University Hospital, Terrassa, Spain.
Xavier UstrellStroke Unit, Department of Neurology, Joan XXIII University Hospital, Terragona, Spain.
Ferran TorresMedical Statistics Core Facility, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Hospital Clinic, Barcelona, Spain.
Luis San RománDepartment of Radiology, Hospital Clínic of Barcelona, Barcelona, Spain.
Mercè Salvat-PlanaDepartment of Health, Pla Director Malaltia Vascular Cerebral (Catalan Stroke Program), Barcelona, Spain.
Francesc Xavier Jiménez-FàbregaEmergency Medical Services of Catalonia, Barcelona, Spain.
Ernest PalomerasDepartment of Neurology, Hospital of Mataró, Mataró, Spain.
Esther CatenaDepartment of Neurology, Consorci Sanitari Garraf Hospital, Sant Pere de Ribes, Spain.
Carla ColomDepartment of Emergency, Hospital of Igualada, Igualada, Spain.
Dolores CochoDepartment of Emergency, Hospital of Granollers, Granollers, Spain.
Juanjo BaigesDepartment of Emergency, Verge de la Cinta Hospital, Tortosa, Spain.
Josep Maria AragonesDepartment of Emergency, Vic University Hospital, Vic, Spain.
Gloria DiazDepartment of Emergency, Hospital of Campdevànol, Campdevànol, Spain.
Xavier CostaDepartment of Emergency, Hospital of Figueres, Figueres, Spain.
María Cruz AlmendrosDepartment of Emergency, Hospital of Palamós, Palamós, Spain.
Maria RybyebaDepartment of Emergency, Hospital of Olot, Olot, Spain.
Miquel BarcelóDepartment of Emergency, Cerdanya Hospital, Puigcerdá, Spain.
Dolors CarriónDepartment of Emergency, Hospital of Móra d'Ebre, Móra d'Ebre, Spain.
Matilde Núria LòpezDepartment of Emergency, Seu d'Urgell Hospital, Seu d'Urgell, Spain.
Eduard SanjurjoDepartment of Emergency, Hospital of Tremp, Tremp, Spain.
Natalia Pérez de la OssaStroke Unit, Department of Neuroscience, Germans Trias Hospital, Badalona, Spain.
Xabier UrraComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
Ángel ChamorroComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
Catalan Stroke Code and Reperfusion (Cat-SCR) ConsortiumComprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.

Funding

European Social FundFondo de Investigacions Sanitarias of the Institut de Salud Carlos III to Ángel Chamorro and Xabier Urra FIS-ISCIII PI18/00444Fondo Europeo de Desarrollo RegionalInstitute of Health Carlos III CM18/00116Instituto de Salud Carlos III INT19/00020
6 · The paper itself

Abstract

background and purposeIn real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors.

methodsRetrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019. The effect of MT on good functional outcome (modified Rankin Score ≤2) and survival at 3 months was studied using inverse probability of treatment weighting (IPTW) analysis in three pre-defined baseline prognostic groups: poor (if pre-stroke disability, age >85 years, National Institutes of Health Stroke Scale [NIHSS] >25, time from onset >6 hours, Alberta Stroke Program Early CT Score <6, proximal vertebrobasilar occlusion, supratherapeutic international normalized ratio >3), good (if NIHSS <6 or distal occlusion, in the absence of poor prognostic factors), or reference (not meeting other groups' criteria).

resultsPatients receiving MT (n=1,996, 77%) were younger, had less pre-stroke disability, and received systemic thrombolysis less frequently. These differences were balanced after the IPTW stratified by prognosis. MT was associated with good functional outcome in the reference (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.0 to 4.4), and especially in the poor baseline prognostic stratum (OR, 3.9; 95% CI, 2.6 to 5.9), but not in the good prognostic stratum. MT was associated with survival only in the poor prognostic stratum (OR, 2.6; 95% CI, 2.0 to 3.3).

conclusionsDespite their worse overall outcomes, the impact of thrombectomy over medical management was more substantial in patients with poorer baseline prognostic factors than patients with good prognostic factors.

Indexed as

OutcomePrognosisPropensity scoreRegistriesStrokeThrombectomy

Identifiers

PMID34649384
PMCPMC8521260

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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.