Endovascular therapy for ischemic stroke Save a minute-save a week

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Endovascular therapy for ischemic stroke Save a minute-save a week

Meretoja, A. (author)

Keshtkaran, M. (author)

Tatlisumak, Turgut (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience

Donnan, G. A. (author)

Churilov, L. (author)

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2017-04-28
2017
English.
In: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 88:22, s. 2123-2127

Related links:: https://gup.ub.gu.se...; show more...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Objective: To quantify the patient lifetime benefits gained from reduced delays in endovascular therapy for acute ischemic stroke. Methods: We used observational prospective data of consecutive stroke patients treated with IV thrombolysis in Helsinki (1998-2014; n = 2,474) to describe distributions of age, sex, stroke severity, onset-to-treatment times, and 3-month modified Rankin Scale (mRS) in routine clinical practice. We used treatment effects by time of endovascular therapy in large vessel occlusion over and above thrombolysis as reported by the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) study to model the shift in 3-month mRS distributions with reducing treatment delays. From the 3-month outcomes we derived patient-expected lifetimes and cumulative long-term disability with incremental treatment delay reductions. Results: Each minute saved in onset-to-treatment time granted on average 4.2 days of extra healthy life, with a 95% prediction interval 2.3-5.4. Women gained slightly more than men due to their longer life expectancies. Patients younger than 55 years with severe strokes of NIH Stroke Scale score above 10 gained more than a week per each minute saved. In the whole cohort, every 20 minutes decrease in treatment delays led to a gain of average equivalent of 3 months of disability-free life. Conclusions: Small reductions in endovascular delays lead to marked health benefits over patients' lifetimes. Services need to be optimized to reduce delays to endovascular therapy.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)

Keyword

POOLED ANALYSIS
TIME
THROMBOLYSIS
REPERFUSION
TRIAL
THROMBECTOMY
METAANALYSIS
IMPROVEMENT
MANAGEMENT
DISABILITY
CADE11th Symposium on Thrombolysis and Acute Stroke Treatment (TAST) - Preparing for the Next

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By the author/editor: Meretoja, A.; Keshtkaran, M.; Tatlisumak, Turg ...; Donnan, G. A.; Churilov, L.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Neurology

Articles in the publication: Neurology

By the university: University of Gothenburg

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