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Data_Sheet_1_Influence of pre-stroke dependency on safety and efficacy of endovascular therapy: A systematic review and meta-analysis.PDF (887.34 kB)

Data_Sheet_1_Influence of pre-stroke dependency on safety and efficacy of endovascular therapy: A systematic review and meta-analysis.PDF

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posted on 2022-09-21, 04:10 authored by Hengxiao Zhao, Xuesong Bai, Wei Li, Qiuyue Tian, Wenjiao Wang, Xiaofan Guo, Yao Feng, Linyan Duan, Adam A. Dmytriw, Aman B. Patel, Tingyu Yi, Wenbo Cao, Xiaoli Min, Wenhuo Chen, Liqun Jiao
Background and purpose

In the landmark trials studying endovascular thrombectomy (EVT), pre-stroke dependent (PSD) patients were generally excluded. This systematic review and meta-analysis aimed to compare the safety and efficacy of EVT between PSD and pre-stroke independent (PSI) patients.

Methods

We searched CENTRAL, Embase, and Ovid MEDLINE up to 11 November 2021 for studies assessing PSD and PSI patients, which were separately defined as pre-stroke mRS score >2 or >1, and ≤2 or ≤1 accordingly. Two authors extracted data and assessed the risk of bias. A meta-analysis was carried out using the random-effects model. Adjusted OR and 95% CI were used to estimate adjusted pool effects. The main outcomes included favorable outcomes, successful recanalization, symptomatic intracranial hemorrhage, and 90-day mortality.

Results

A total of 8,004 records met the initial search strategy, and ten studies were included in the final decision. Compared with PSImRS≤2, PSDmRS>2 had a lower favorable outcome (OR 0.51; 95% CI, 0.33–0.79) and higher 90-day mortality (OR 3.32; 95% CI, 2.77–3.98). No significant difference was found in successful recanalization and sICH. After adjustment, only 90-day mortality (aOR 1.99; 95% CI, 1.58–2.49) remained significantly higher in PSDmRS>2. Compared with PSImRS≤1, PSDmRS>1 had lower 90-day mortality (OR, 3.10; 95% CI, 1.84–5.24). No significant difference was found regarding the favorable outcome, successful recanalization, and sICH. After adjustment, no significant difference was found in a favorable outcome, but a higher rate of 90-day mortality (aOR, 2.13; 95% CI, 1.66–2.72) remained in PSDmRS>1.

Conclusions

PSD does not innately influence the EVT outcomes regarding sICH and favorable outcomes but may increase the risk of 90-day mortality. Until further evidence is available, it is reasonable to suggest EVT for patients with PSD.

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