NIHSS 24 h After Mechanical Thrombectomy Predicts 90-Day Functional Outcome

Hendrix, Philipp; Melamed, Itay; Collins, Malie; Lieberman, Noah; Sharma, Vaibhav; Goren, Oded; Zand, Ramin; Schirmer, Clemens M.; Griessenauer, Christoph J.

doi:10.1007/s00062-021-01068-4

Cited by 24 publications

(20 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They identified the NIHSS at 24 hours with a threshold of ≤8 to serve as the best NIHSS surrogate for functional outcome in anterior circulation LVO stroke 1. Eventually, Hendrix et al could validate these observations and also found that NIHSS ≤8 24 hours after MT outperforms other NIHSS surrogates for 90-day functional outcome prediction in anterior circulation LVO stroke 2. Repeated by Mistry et al , an absolute NIHSS ≤7 at 24 hours outperformed other NIHSS surrogates 5.…”

mentioning

confidence: 93%

“…About 16% of patients in studies by Meyer et al and Hendrix et al did not have a favorable outcome despite achieving the 24-hour NIHSS surrogate ≤8. Older patient age was the predominant risk factor in both studies 1 2…”

mentioning

confidence: 95%

“…Early clinical surrogates for long-term functional outcomes represent valuable clinical adjuncts. Lately, the National Institutes of Health Stroke Scale (NIHSS) score 24 hours after mechanical thrombectomy (MT) for large vessel occlusion (LVO) ischemic stroke has been repeatedly demonstrated to serve as a robust and independent predictor of 90-day functional outcomes 1–5…”

mentioning

confidence: 99%

See 2 more Smart Citations

Relative versus absolute early neurological improvement after mechanical thrombectomy for large vessel occlusion stroke – hot or not?

Hendrix

Schirmer

2022

J NeuroIntervent Surg

Self Cite

View full text Add to dashboard Cite

mentioning

confidence: 93%

mentioning

confidence: 95%

mentioning

confidence: 99%

See 1 more Smart Citation

Relative versus absolute early neurological improvement after mechanical thrombectomy for large vessel occlusion stroke – hot or not?

Hendrix

Schirmer

2022

J NeuroIntervent Surg

Self Cite

View full text Add to dashboard Cite

“…arly neurological status and early neurological improvement are significant predictors of functional outcome at 90 days after mechanical thrombectomy (MT) and IV thrombolysis in patients with anterior circulation stroke. [1][2][3][4][5][6][7][8][9][10] However, in some patients, an early clinical response is not observed. 3 Nevertheless, a subgroup of these patients experiences delayed clinical recovery and still achieves good functional outcome.…”

mentioning

confidence: 99%

How Much of the Thrombectomy Related Improvement in Functional Outcome Is Already Apparent at 24 Hours and at Hospital Discharge?

Kniep

Meyer

Bechstein

et al. 2022

Stroke

View full text Add to dashboard Cite

Background: Early neurological status has been described as predictor of functional outcome in patients with anterior circulation stroke after mechanical thrombectomy. It remains unclear to what proportion the improvement of functional outcome at day 90 is already apparent at 24 hours and at hospital discharge and how later factors impact outcome. Methods: All patients enrolled in the German Stroke Registry (June 2015–December 2019) with anterior circulation stroke and availability of baseline data and neurological status were included. A mediation analysis was conducted to investigate the effect of successful recanalization (Thrombolysis in Cerebral Infarction scale score ≥2b) on good functional outcome (modified Rankin Scale score ≤2 at day 90) with mediation through neurological status (National Institutes of Health Stroke Scale [NIHSS] at 24 hours and at hospital discharge). Results: Three thousand fifty-seven patients fulfilled the inclusion criteria, thereof 2589 (85%) with successful recanalization and 1180 (39%) with good functional outcome. In a multivariate logistic regression analysis, probability of good outcome was significantly associated with age (odds ratio [95% CI], 0.95 [0.94–0.96]), prestroke modified Rankin Scale (0.48 [0.42–0.55]), admission-NIHSS (0.96 [0.94–0.98]), 24-hour NIHSS (0.83 [0.81–0.84]), diabetes (0.56 [0.43–0.72]), proximal middle cerebral artery occlusions (0.78 [0.62–0.97]), passes (0.88 [0.82–0.95]), Alberta Stroke Program Early CT Score (1.07 [1.00–1.14]), successful recanalization (2.39 [1.68–3.43]), intracerebral hemorrhage (0.51 [0.35–0.73]), and recurrent strokes (0.54 [0.32–0.92]). Mediation analysis showed a 20 percentage points (95% CI‚ 17–24 percentage points) increase of probability of good functional outcome after successful recanalization. Fifty-four percent (95% CI‚ 44%–66%) of the improvement in functional outcome was explained by 24-hour NIHSS and 75% (95% CI‚ 62%–90%) by NIHSS at hospital discharge. Conclusions: Fifty-four percent of the improvement in functional outcome after successful recanalization is apparent in NIHSS at 24 hours, 75% in NIHSS at hospital discharge. Other unknown factors not apparent in NIHSS at the 2 time points investigated account for the remaining effect on long term outcome, suggesting, among others, clinical relevance of delayed neurological improvement and deterioration. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03356392.

show abstract

“…Observation indicators. After 24 h, 7 days, and 90 days, the neurological function was evaluated regularly, including National Institute of Health Stroke Scale (NIHSS) score (NIHSS score) and modified Rankin Scale (mRS) [5]. The effective treatment is defined as the NIHSS score decreased by ≥ 4 points or the symptoms disappeared completely at 24 h after treatment, and the good neurological function is defined as the improved Rankin scale score ≤ 2 points after 90 days.…”

mentioning

confidence: 99%

Clinical comparison of intravenous thrombolysis and bridging artery thrombectomy in hyperacute ischemic stroke with unknown time of onset

et al. 2021

View full text Add to dashboard Cite

IntroductionThe aim of the study was to explore the clinical efficacy and safety of intravenous thrombolysis and bridging artery thrombectomy for hyperacute ischemic stroke with unknown onset time.Material and methodsOne hundred and twenty-eight patients with hyperacute cerebral infarction and without a clear time of onset were randomly divided into intravenous thrombolysis (n = 66) and bridging artery thrombectomy groups (n = 62).ResultsIn the intravenous thrombolysis group, 37 patients’ vessels had recanalization, 32 patients’ 24-hour National Institute of Health Stroke Scale (NIHSS) score improved, and 42 patients’ 90-day modified Rankin Scale (mRS) score was good. In the bridging artery thrombectomy group, 62 patients’ vessels had recanalization, 28 patients’ 24-hour NIHSS score improved, and 38 patients’ 90-day mRS score was good.ConclusionsThe benefits and adverse events between intravenous thrombolysis and bridging artery thrombectomy for ischemic stroke with unknown time of onset are similar.

show abstract

NIHSS 24 h After Mechanical Thrombectomy Predicts 90-Day Functional Outcome

Cited by 24 publications

References 15 publications

Relative versus absolute early neurological improvement after mechanical thrombectomy for large vessel occlusion stroke – hot or not?

Relative versus absolute early neurological improvement after mechanical thrombectomy for large vessel occlusion stroke – hot or not?

How Much of the Thrombectomy Related Improvement in Functional Outcome Is Already Apparent at 24 Hours and at Hospital Discharge?

Clinical comparison of intravenous thrombolysis and bridging artery thrombectomy in hyperacute ischemic stroke with unknown time of onset

Contact Info

Product

Resources

About

NIHSS 24 h After Mechanical Thrombectomy Predicts 90-Day Functional Outcome

Cited by 24 publications

References 15 publications

Relative versus absolute early neurological improvement after mechanical thrombectomy for large vessel occlusion stroke – hot or not?

Relative versus absolute early neurological improvement after mechanical thrombectomy for large vessel occlusion stroke – hot or not?

How Much of the Thrombectomy Related Improvement in Functional Outcome Is Already Apparent at 24 Hours and at Hospital Discharge?

Clinical comparison of intravenous thrombolysis and bridging artery thrombectomy in hyperacute ischemic stroke with unknown time of onset

Contact Info

Product

Resources

About

NIHSS 24 h After Mechanical Thrombectomy Predicts 90-Day Functional Outcome