Impact of smoking on one year functional outcomes after thrombectomy for young stroke patients

Abstract

BackgroundThe incidence of stroke in young patients (20–50 years old) has increased in recent decades. Unlike the use of good functional outcomes to evaluate prognosis, excellent functional outcomes are a better indicator of return to work among younger patients. The rate of return to work increases with time after stroke. This study investigated the short term (3 months) and long term (1 year) predictors of excellent functional outcomes in young patients after endovascular thrombectomy (EVT).MethodsWe included young patients who underwent EVT for acute ischemic stroke (AIS) due to large vessel occlusion within 6 hours after stroke onset between 2015 and 2021. Patients with intracerebral hemorrhage on pretreatment CT were excluded. The associations between clinical, imaging, and procedure variables, and excellent functional outcomes were analyzed using univariate and multivariable logistic regression analyses. An excellent functional outcome was defined as a modified Rankin Scale score of ≤1.ResultsOf the 361 patients with AIS eligible for EVT, 55 young patients (aged 24–50 years) were included. Of these, 36.4% and 41.8% achieved excellent functional outcomes at 3 and 12 months, respectively. Multivariate analysis revealed that smoking was the independent negative predictor of both 3 month (adjusted OR (aOR) 0.232, 95% CI 0.058 to 0.928; p=0.039) and 12 month (aOR 0.180, 95% CI 0.044 to 0.741; p=0.018) excellent functional outcomes.ConclusionsCurrent or former smoking habit was an independent negative predictor of both short term and long term excellent functional outcomes in young adults with AIS.

Long term for patients with futile endovascular reperfusion after stroke

“…In recent years, studies involving anterior and posterior stroke have shown that the proportion of patients with favorable outcomes after thrombectomy has ranged from 36% to 69.1%, and mortality has ranged from 12.7% to 26% at 1 year. 16,17 In our study, it is obvious that the long-term mortality and unfavorable outcome rates were high because of the inclusion of patients with posterior circulation infarction and the special focus on patients with FR.…”

Night shift work was associated with functional outcomes in acute ischemic stroke patients treated with endovascular thrombectomy

“…Smoking can increase the permeability of the blood-brain barrier and disruption transport, causing brain edema after stroke and worsening the prognosis [ 19 ]. One study found that current or former smoking habits were independent negative predictors of 3- and 12-month functional outcomes in young patients after EVT [ 20 ]. It is worth noting that night shift work is more likely to lead to unhealthy lifestyles, which could also impact comorbidity and stroke outcomes.…”

Risk factors for stroke recurrence in young patients with first-ever ischemic stroke: A meta-analysis

“…Ischemic stroke is a disease with a high incidence rate, high recurrence rate and high disability rate, affecting approximately 12 million patients worldwide every year, of which approximately 10% occur in individuals under 50 years old[ 7 , 8 ]. At present, the definition of youth stroke is not yet unified, and different studies have different definitions of its age limit.…”