O-018 Thrombectomy outcomes in patients with low aspects treated within 24 hours of symptoms onset: insights from STAR
Notice bibliographique
Résumé
Introduction Outcomes of mechanical thrombectomy (MT) depends largely of achieving reperfusion of a salvageable brain tissue. Patients with poor baseline images were excluded from most clinical trials so the data about their outcomes remain scarce and whether these patients could still benefit from MT remains unknown. In this study, we aim to investigate the safety and efficacy of EVT in patients with large vessel occlusion and large core infarct. Methods The Stroke Thrombectomy and Aneurysm Registry (STAR) that combined the prospectively maintained databases of 28 thrombectomy-capable stroke centers in the US, Europe, and Asia was interrogated. We included thrombectomy patient presenting with emergent large vessel occlusion within 24 hours and with a large core infarct as defined by Alberta Stroke Program Early CT Score (ASPECTS) < 6. Patients presenting within 6 hours of last known normal (LKN) were considered in the early window and patients presenting after 6 hours were considered in the late window. 90-day outcomes were assessed using modified Rankin scale (mRS)We used a logistic regression model to assess the factors associated with good 90-day outcome in patients in the early and late thrombectomy window. Results 144 patients were included in this study (table). Median age was 69 and 92 (64%) patients were treated in the early MT window. M1 was the most common site of occlusion (51.4%) and ADAPT was used in 34.7%. Median admission NIHSS was 17.5. Successful recanalization (TICI>2b) was achieved in 84.7% and median procedure time was 54 minutes. sICH hemorrhage was observed in 22 (15.3%). Regarding 90-day outcome, median mRS was 4, favorable outcome (mRS 0-2) was observed in 41 patients (28.5%) and mortality occurred in in 59 (41%). There was no difference in 90-day functional outcome between patients in early and late windows. In patients presenting in the early window, age (aOR=0.905, p=0.0002; CI=0.858-0.954) and baseline NIHSS (aOR=0.909, p=0.0423; CI=0.829-0.997) were independently associated with 90-day outcome. In patients presenting in the late window, only age (aOR=0.934, p=0.0069; CI=0.888-0.981) was independently associated with good outcome. Conclusion More than one in four patients presenting with ASPECTS<6 may achieve functional independence at 90-day following MT. Patient age remained the main predictors of 90-day outcome in patients with low ASPECTS in both late and early window. Disclosures Z. Hubbard: None. G. Porto: None. S. Al Kasab: None. E. Almallouhi: None. A. Alawieh: None. R. De Leacy: None. D. Raper: None. A. Rai: None. T. Dumont: None. S. Wolfe: None. P. Jabbour: None. C. Ogilvy: None. P. Park: None. M. Levitt: None. A. Polifka: None. R. Crowley: None. A. Arthur: None. J. Osbun: None. R. Crosa: None. I. Maier: None. K. Burchiel: None. J. Grossberg: None. S. Chowdhry: None. M. Mokin: None. C. Matouk: None. R. Williamson: None. A. Yoo: None. J. Mascitelli: None. P. Kan: None. M. Psychogios: None. R. Starke: None. A. Spiotta: None.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».