Evidence map›Paper›PMID 41816510›Full record

ArticleStroke (Hoboken, N.J.)2026

Impact of Severe Prestroke Disability on Outcomes After Mechanical Thrombectomy: A Multicenter Analysis.

Hannah Asperger, Felix Bode, Taraneh Ebrahimi, Christine Kindler, Julia Layer, Julius Nicolai Meißner, Louisa Nitsch, Omid Shirvani, Christian Thielscher, Niklas Michael von Danwitz and 5 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke (Hoboken, N.J.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03356392 (German Stroke Registry - Endovascular Treatment), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT03356392 recruitingnot on this map

German Stroke Registry - Endovascular Treatment

Typeobservational_patient_registrySponsorUniversitätsklinikum Hamburg-EppendorfRan2015 to 2027Enrolled10,000ConditionsAcute Ischemic StrokeArmstelephone call d90
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Hannah AspergerDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0003-3253-7016
Felix BodeDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0003-4498-186X
Taraneh EbrahimiDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0002-5471-4266
Christine KindlerDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0002-6711-3347
Julia LayerDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.
Julius Nicolai MeißnerDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0002-8980-9337
Louisa NitschDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0002-5139-6848
Omid ShirvaniDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0009-0006-6367-8742
Christian ThielscherDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0002-7109-4820
Niklas Michael von DanwitzDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.
Johannes WellerDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0001-5818-5392
Franziska DornDepartment of Neuroradiology (F.D.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0001-9093-8307
Gabor C PetzoldDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0002-0145-8641
Sebastian StösserDepartment of Vascular Neurology (H.A., F.B., T.E., C.K., J.L., J.N.M., L.N., O.S., C.T., N.M.v.D., J.W., G.C.P., S.S.), University Hospital Bonn, Germany.ORCID https://orcid.org/0000-0002-1182-705X
GSR-ET Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with severe prestroke disability (PSD) remain underrepresented in mechanical thrombectomy studies, despite their growing relevance in aging populations. This study used data from the German Stroke Registry-Endovascular Treatment to evaluate functional recovery, mortality, and poststroke care outcomes in this high-risk population.

methodsWe analyzed 9456 mechanical thrombectomy-treated patients with stroke from the German Stroke Registry-Endovascular Treatment (2015-2021), categorized by premorbid modified Rankin Scale (mRS): no PSD (mRS score, 0-1), moderate PSD (mPSD; mRS score, 2-3), and severe PSD (sPSD; mRS score, 4-5). Favorable outcomes were defined as an mRS score of 0 to 2 or return to baseline. Logistic regression adjusted for age, National Institutes of Health Stroke Scale, intravenous thrombolysis, reperfusion success, and sex was used to predict outcomes. A neural network subsequently explored feature importance.

resultsAmong 9456 patients, 7387 had no PSD, 1648 mPSD, and 421 sPSD. Unadjusted 90-day outcomes showed increasing mortality with PSD severity and fewer favorable outcomes in both PSD groups. At 90 days, favorable outcomes occurred in 3020 patients without PSD (40.9%), 232 with mPSD (14.1%), and 85 with sPSD (20.2%). After adjustment, only mPSD was associated with lower odds of favorable outcomes, while both mPSD and sPSD remained independent predictors of higher mortality. Complication rates were similar across groups, except for higher vasospasm in patients without PSD. Including rebalanced sPSD samples in predictive models resulted in minor performance improvements but notable shifts in feature importance, with age and Alberta Stroke Program Early Computed Tomography Score emerging as key predictors, National Institutes of Health Stroke Scale decreasing in relevance, and factors such as local anesthesia and occlusion location becoming more prominent.

conclusionsDespite higher mortality, approximately a fifth of patients with PSD achieved favorable outcomes, suggesting that this group should not be routinely excluded from mechanical thrombectomy. Further studies should refine patient selection criteria and outcome definitions for this vulnerable population. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03356392.

Indexed as

dementiapatient dischargesample sizestrokethrombectomy

Identifiers

PMID41816510
PMCPMC12959425

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Registered trials

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.