Association between the time of day at stroke onset and functional outcome of acute ischemic stroke patients treated with endovascular therapy

Abstract

To investigate the association between time-of-day of stroke onset and functional outcome in patients with acute ischemic stroke(AIS) treated with endovascular thrombectomy(EVT). AIS patients treated with EVT between January 2013 and December 2018 were recruited and divided them into four 6-h interval groups according to the time-of-day of stroke onset. A total of 438 patients were enrolled, 3-month favorable outcome were achieved in 58.6%, 43.7%, 36.6%, and 30.5% of patients in the 00:00–06:00, 06:00–12:00, 12:00–18:00, and 18:00–24:00 groups, respectively (adjusted OR 0.61, 95% CI 0.40–0.93; p = 0.020). Compared with the 18:00–24:00 interval, patients in the 00:00–06:00 interval (adjusted OR 4.01, 95%CI 1.02–15.80, p = 0.047) and the 06:00–12:00 interval (adjusted OR 3.24, 95% CI 1.09–9.64, p = 0.034) were more likely to achieve favorable outcome. The time-of-day of stroke onset was not associated with 3-month mortality (adjusted p = 0.829), symptomatic intracerebral hemorrhage (sICH, adjusted p = 0.296), or early successful recanalization (adjusted p = 0.074). In conclusion, in AIS patients treated with EVT, those onsets either between 00:00 and 06:00 or between 06:00 and 12:00 appeared to be associated with a higher proportion of favorable outcomes at 3 months, but the time-of-day at stroke onset was not associated with the incidence of sICH, rate of early successful recanalization, or 3-month mortality.

Influence of Temperature Chronobiology on Stroke Outcome

“…Recently, the association between the time of day and the outcome of ischemic stroke patients treated with endovascular thrombectomey has been described [ 38 ]. Opposite of our results, in these patients, good outcomes at 3 months were observed in those who suffered ischemic stroke at night.…”

“…Opposite of our results, in these patients, good outcomes at 3 months were observed in those who suffered ischemic stroke at night. This study proposed that the lower body temperature at night, among other factors, may have had a potential impact on their results [ 38 ]. Conversely, other studies have claimed that, although suffering a stroke at night is less frequent, they usually are more severe [ 26 , 39 ] and exhibit faster infarct progression [ 40 ], which supports the data observed in the present study.…”

The effect of intravenous thrombolysis on patients with successful thrombectomy depends on final reperfusion grade: A retrospective study

“…Third, without advanced neuroimaging results, we can only suggest a hypothesis rather than a more concrete explanation of our findings. Perioperative dynamic perfusion imaging in future research may further elucidate potential mechanisms, such as improving microvascular compromise in no‐reflow phenomenon 25 …”

Higher fasting blood glucose was associated with worse in‐hospital clinical outcomes in patients with primary intracerebral hemorrhage: From a large‐scale nationwide longitudinal registry

“…Prior statin was associated with reduced proportion of evacuation of intracranial hematoma without increasing mortality during in‐hospitalization 26 . The cost‐effectiveness ratio of anticoagulant therapy is still uncertain in ICH and more investigations are warranted, 27,28 as well as the role of platelets and onset time that have been studied in subarachnoid hemorrhage 29 and ischemic stroke 30 …”

“… 26 The cost‐effectiveness ratio of anticoagulant therapy is still uncertain in ICH and more investigations are warranted, 27 , 28 as well as the role of platelets and onset time that have been studied in subarachnoid hemorrhage 29 and ischemic stroke. 30 …”