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Prediction modellin...
Prediction modelling the impact of onset to treatment time on the modified Rankin Scale score at 90 days for patients with acute ischaemic stroke
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- Ennab Vogel, Nicklas (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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- Tatlisumak, Turgut (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Neurology, Sahlgrenska University Hospital, Göteborg, Sweden; Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg Sahlgrenska Academy, Göteborg, Sweden,Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden
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- Wester, Per, 1959- (författare)
- Umeå universitet,Avdelningen för medicin,Department of Clinical Science, Karolinska Institute Danderyds Hospital, Stockholm, Sweden,Umea Univ, Sweden; Karolinska Inst, Sweden
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- Lyth, Johan, 1980- (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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- Levin, Lars-Åke (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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(creator_code:org_t)
- 2022-08-16
- 2022
- Engelska.
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Ingår i: BMJ Neurology Open. - : BMJ. - 2632-6140. ; 4:2
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://liu.diva-por... (primary) (Raw object)
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Introduction Shortening the time from stroke onset to treatment increases the effectiveness of endovascular stroke therapies. Aim This study aimed to predict the modified Rankin Scale score at 90 days post-stroke (mRS-90d score) in patients with acute ischaemic stroke (AIS) with respect to four types of treatment: conservative therapy (CVT), intravenous thrombolysis only (IVT), mechanical thrombectomy only (MT) and pretreatment with IVT before MT (IVT+MT). Patients and methods This nationwide observational study included 124 484 confirmed cases of acute stroke in Sweden over 6 years (2012-2017). The associations between onset-to-treatment time (OTT), patient age and hospital admission National Institutes of Health Stroke Scale (NIHSS) score with the five-levelled mRS-90d score were retrospectively studied. A generalised linear model (GLM) was fitted to predict the mRS-90d scores for each patient group. Results The fitted GLM for CVT patients is a function of age and NIHSS score. For IVT, MT and IVT+MT patients, GLMs additionally employed OTT variables. By reducing the mean OTTs by 15 min, the number needed-to-treat (NNT) for one patient to make a favourable one-step shift in the mRS was 30 for IVT, 48 for MT and 21 for IVT+MT. Discussion and conclusion This study demonstrates linear associations of mRS-90d score with OTT for IVT, MT and IVT+MT, and shows in absolute effects measures that OTT reductions for IVT and/or MT produces substantial health gains for patients with AIS. Even moderate OTT reductions led to sharp drops in the NNT. © 2022 Author(s) (or their employer(s)).
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Interventional
- MRS
- Statistics
- Stroke
- acute ischemic stroke
- age distribution
- aged
- Article
- blood clot lysis
- cerebrovascular accident
- clinical outcome
- conservative treatment
- controlled study
- female
- hospital admission
- human
- major clinical study
- male
- mechanical thrombectomy
- National Institutes of Health Stroke Scale
- numbers needed to treat
- observational study
- predictive model
- Rankin scale
- retrospective study
- stroke patient
- time to treatment
- Interventional
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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