Five-Year Cumulative Cost Saving with Thrombolysis in Korea: 3-Month Disability-Based Estimation

Hong, Keun‐Sik; Kim, Seong‐Eun; Bae, Hee‐Joon

doi:10.5853/jos.2020.00556

Cited by 1 publication

(1 citation statement)

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“…25 26 While outcomes after stroke can be difficult to predict, 27 efforts to prevent accumulated disability are likely to be highly cost-effective given reductions in morbidity, nursing requirements, and long-term costs after stroke, in addition to quality of life benefits. [28][29][30][31][32] Indeed, growing evidence supports the importance of patients' perspectives on quality of life. 33 Further evaluations investigating these additional outcomes are warranted.…”

Section: Discussionmentioning

confidence: 99%

Toward a more inclusive paradigm: thrombectomy for stroke patients with pre-existing disabilities

Regenhardt

Young

Etherton

et al. 2020

J NeuroIntervent Surg

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BackgroundPersons with pre-existing disabilities represent over one-third of acute stroke presentations, but account for a far smaller proportion of those receiving endovascular thrombectomy (EVT) and thrombolysis. This is despite existing ethical, economic, legal, and social directives to maximize equity for this vulnerable population. We sought to determine associations between baseline modified Rankin Scale (mRS) and outcomes after EVT.MethodsIndividuals who underwent EVT were identified from a prospectively maintained database. Demographics, medical history, presentations, treatments, and outcomes were recorded. Baseline disability was defined as baseline mRS≥2. Accumulated disability was defined as the delta between baseline mRS and absolute 90-day mRS.ResultsOf 381 individuals, 49 had baseline disability (five with mRS=4, 23 mRS=3, 21 mRS=2). Those with baseline disability were older (81 vs 68 years, P<0.0001), more likely female (65% vs 49%, P=0.032), had more coronary disease (39% vs 20%, P=0.006), stroke/TIA history (35% vs 15%, P=0.002), and higher NIH Stroke Scale (19 vs 16, P=0.001). Baseline mRS was associated with absolute 90-day mRS ≤2 (OR=0.509, 95%CI=0.370–0.700). However, baseline mRS bore no association with accumulated disability by delta mRS ≤0 (ie, return to baseline, OR=1.247, 95%CI=0.943–1.648), delta mRS ≤1 (OR=1.149, 95%CI=0.906–1.458), delta mRS ≤2 (OR 1.097, 95% CI 0.869–1.386), TICI 2b–3 reperfusion (OR=0.914, 95%CI=0.712–1.173), final infarct size (P=0.853, β=−0.014), or intracerebral hemorrhage (OR=0.521, 95%CI=0.244–1.112).ConclusionsWhile baseline mRS was associated with absolute 90-day disability, there was no association with accumulated disability or other outcomes. Patients with baseline disability should not be routinely excluded from EVT based on baseline mRS alone.

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Section: Discussionmentioning

confidence: 99%

Toward a more inclusive paradigm: thrombectomy for stroke patients with pre-existing disabilities

Regenhardt

Young

Etherton

et al. 2020

J NeuroIntervent Surg

View full text Add to dashboard Cite

show abstract

Five-Year Cumulative Cost Saving with Thrombolysis in Korea: 3-Month Disability-Based Estimation

Abstract: has received lecture honoraria and research grants from Boehringer Ingelheim Korea related to the current topic. Dr. Hee-Joon Bae was involved as a site investigator of a multicenter clinical trial sponsored by Boehringer Ingelheim.

Cited by 1 publication

References 8 publications

Toward a more inclusive paradigm: thrombectomy for stroke patients with pre-existing disabilities

Toward a more inclusive paradigm: thrombectomy for stroke patients with pre-existing disabilities

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