TIME TO ENDOVASCULAR TREATMENT AND FUNCTIONAL OUTCOME IN ACUTE ISCHEMIC STROKE OF THE POSTERIOR CIRCULATION
- Nikki Boodt (Netherlands)
Abstract
Group Name
on behalf of the MR CLEAN Registry Investigators
Background And Aims
Delay in start of endovascular treatment (EVT) for acute ischemic stroke results in worse functional outcome. However, the magnitude of this effect in patients with posterior circulation ischemic stroke (PCS) is not well known. We aim to assess the association of time to EVT with outcome in patients with PCS.
Methods
We included patients from the MR CLEAN registry who underwent EVT for PCS between March 2014 and December 2018, within 6 hours of stroke onset. We assessed the association between time from estimated stroke onset to start of EVT and functional outcome (90-day mRS score) and functional independence (mRS 0-2) with univariable and multivariable ordinal and binary logistic regression, and calculated absolute probabilities of functional independence and death per hour delay.
Results
Of 264 patients who underwent EVT for PCS, 183 (69%) received EVT within 6 hours of stroke onset. In these patients, increased time to EVT was associated with worse outcomes; acOR per one hour delay to EVT was 0.86 (95% CI, 0.67-1.08) for the full mRS, and 0.74 (95% CI, 0.55-1.00) for functional independence (Figure). Per hour delay to EVT, the probability for functional independence decreased with 6.4%, and the probability for death increased with 2.3%.
Conclusions
In patients undergoing EVT for PCS within 6 hours from stroke onset, increased time to EVT is associated with worse outcomes. The detrimental effect of this delay is similar to the effect observed in strokes in the anterior circulation.