Endovascular Thrombectomy (Evt) For Stroke : Effectiveness in Routine Practice in a Canadian Teaching Centre
Bibliographic record
Abstract
BACKGROUND: EVT is recommended as standard of care in Canada. However, there is limited data about its effectiveness in routine practice. We compared patient outcomes after EVT versus routine medical care in Halifax, the only centre performing EVT in the province of Nova Scotia. Methods: Using our prospective stroke registry (maintained since 1997), we identified all patients who underwent EVT after our participation in the ESCAPE trial between Feb 1, 2013 until Jan 31, 2017, and matched them in a hierarchical fashion with control patients who did not receive EVT based on age (5 years), pre-hospital functional status, stroke syndrome, severity, and thrombolysis administration. Demographics, in-hospital mortality, discharge disposition from acute care, and length of stay in hospital (including rehabilitation) were compared between cases and controls. Results: We identified 45 cases and 45 controls. 51% of the cases and 57% of the controls were female. We demonstrated a statistically significant reduction in in-hospital mortality, favouring intervention with EVT n=5 (22.7%) compared to n=17 (77.3%) (P = 0.006). Of the survivors, casesu2019 median length of stay in acute care was 13 days (range 2-105), which was shorter compared to the controlsu2019 20 days (range 2-149) (P =0.239). Similarly, median length of stay in hospital for cases was 37 days shorter than controls (P = 0.54). Patients who received EVT were also more likely to be discharged home from acute care 13 (57.5%) compared to controls 9 (32.1%) (P=0.05). Conclusion: EVT significantly reduced in-hospital mortality post-stroke. There were nonsignificant trends in favour of EVT for discharge home from acute care, and length of stay in hospital, including in-patient rehabilitation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.007 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.055 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.008 | 0.029 |
| Open science | 0.012 | 0.006 |
| Research integrity | 0.002 | 0.006 |
| Insufficient payload (model declined to judge) | 0.004 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".