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Outcome Predictors in Acute Basilar Artery Occlusion

Published online by Cambridge University Press:  23 September 2014

Tomáš Dornák ,
Roman Herzig ,
David Školoudík ,
Daniel Šanák ,
Martin Kuliha ,
Martin Roubec ,
Martin Köcher ,
Václav Procházka ,
Michal Král  and
Tomáš Veverka
...Show all authors
Tomáš Dornák
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Roman Herzig*
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
David Školoudík
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc Department of Neurology, University Hospital and Ostrava University, Ostrava-Poruba, Czech Republic
Daniel Šanák
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Martin Kuliha
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc Department of Neurology, University Hospital and Ostrava University, Ostrava-Poruba, Czech Republic
Martin Roubec
Affiliation:
Department of Neurology, University Hospital and Ostrava University, Ostrava-Poruba, Czech Republic
Martin Köcher
Affiliation:
Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Václav Procházka
Affiliation:
Department of Radiology, University Hospital and Ostrava University, Ostrava-Poruba, Czech Republic
Michal Král
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Tomáš Veverka
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Petr Hluštík
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Jana Zapletalová
Affiliation:
Department of Medical Biophysics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacký University, Olomouc
Miroslav Herman
Affiliation:
Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
*
*Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, I. P. Pavlova 6, CZ-775 20 Olomouc, Czech Republic. Email: [email protected]
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Abstract

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Objective:

To identify predictors of good outcome in acute basilar artery occlusion (BAO).

Background:

Acute ischemic stroke (AIS) caused by BAO is often associated with a severe and persistent neurological deficit and a high mortality rate.

Methods:

The set consisted of 70 consecutive AIS patients (51 males; mean age 64.5±14.5 years) with BAO. The role of the following factors was assessed: baseline characteristics, stroke risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, estimated time to therapy procedure initiation, treatment method, recanalization rate, change in neurological deficit, post-treatment imaging findings. 30- and 90-day outcome was assessed using the modified Rankin scale with a good outcome defined as a score of 0–3.

Results:

The following statistically significant differences were found between patients with good versus poor outcomes: mean age (54.2 vs. 68.9 years; p=0.0001), presence of arterial hypertension (52.4% vs. 83.7%; p=0.015), diabetes mellitus (9.5% vs. 55.1%; p=0.0004) and severe stroke (14.3% vs. 65.3%; p=0.0002), neurological deficit at time of treatment (14.0 vs. 24.0 median of National Institutes of Health Stroke Scale [NIHSS] points; p=0.001), successful recanalization (90.0% vs. 54.2%; p=0.005), change in neurological deficit (12.0 vs. 1.0 median difference of NIHSS points; p=0.005). Stepwise binary logistic regression analysis identified age (OR=0.932, 95% CI=0.882–0.984; p=0.012), presence of diabetes mellitus (OR=0.105, 95% CI=0.018–0.618; p=0.013) and severe stroke (OR=0.071, 95% CI=0.013–0.383; p=0.002) as significant independent negative predictors of good outcome.

Conclusions:

In the present study, higher age, presence of diabetes mellitus and severe stroke were identified as significant independent negative predictors of good outcome.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 3 , May 2014 , pp. 368 - 374
Copyright
Copyright © The Canadian Journal of Neurological 2014

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