ArticleStroke (Hoboken, N.J.)2024
Anterior Circulation Thrombectomy in Patients With Low National Institutes of Health Stroke Scale Score: Analysis of the National Inpatient Sample.
Article in Stroke (Hoboken, N.J.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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.
Who cites it
3 citing papers in PubMed.
- Article
- How Low Do We Go? NIHSS in Anterior Circulation Thrombectomy Decision-Making.Stroke (Hoboken, N.J.) · 2024Article
- CLEAR Thrombectomy Score: An Index to Estimate the Probability of Good Functional Outcome With or Without Endovascular Treatment in the Late Window for Anterior Circulation Occlusion.Journal of the American Heart Association · 2024Observational
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Prior studies have shown benefit for endovascular therapy (EVT) in patients with large-vessel occlusion and severe deficits, as captured by the National Institutes of Health Stroke Scale (NIHSS). However, the benefit of EVT in patients with NIHSS score of <6 is unclear. Methods: We queried the National Inpatient Sample (2018-2020) for patients with a large-vessel occlusion of the internal carotid or middle cerebral artery with an NIHSS score of <6, and compared outcomes between patients treated with EVT versus best medical management, using propensity score matching. The primary outcome was routine discharge (home or self-care). Secondary outcomes were in-hospital mortality, intracerebral hemorrhage, and length of stay. Primary and secondary outcomes were evaluated using multivariable regression adjusted for baseline characteristics, stroke severity, and treatment with thrombolysis. Results: Of the 212 515 patients with an internal carotid artery/middle cerebral artery stroke, 49 115 met the inclusion criteria for our study. There were 3490 (7.1%) patients treated with EVT and 45 625 (92.9%) treated with best medical management. Patients treated with EVT had no difference in ofdds of routine discharge (adjusted odds ratio (OR), 0.99; 95% CI, 0.82-1.19; Conclusion: Patients treated with EVT compared with best medical management had worse clinical outcomes, and this may be attributable to residual confounding (eg, deterioration following an initially low NIHSS score) or procedural factors. Patients treated with intravenous thrombolysis had greater odds of routine discharge. Our findings suggest potential real-world benefits for intravenous thrombolysis in patients with occlusion of the internal carotid artery/middle cerebral artery and low NIHSS score.
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