Predictive factors for very poor outcomes after endovascular thrombectomy in anterior circulation large vessel occlusion: a multicentre retrospective study in China

作者：Zhixia Li, Jiheng Hao, Changming Wen, Tao Cheng, Yanxin Zhao, Xuesong Bai, Xiaofan Guo, Wenbo Cao, Tianhua Li, Xiaoli Min, Liqun Jiao, Liyong Zhang, Bin Yang · 发表于：BMJ Open · 年份：2025 · DOI：10.1136/bmjopen-2025-101244 · 被引用次数：4 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Venous Thromboembolism Diagnosis and Management

OBJECTIVE: This study aims to investigate the predictors of very poor outcomes in patients with acute ischaemic stroke due to large vessel occlusion after successful endovascular thrombectomy. DESIGN: multicentre, retrospective study. SETTING: Data were derived from tertiary care facilities in five cities of China. PARTICIPANTS: This study included 1242 patients with anterior circulation large-vessel occlusion who underwent endovascular thrombectomy, and they were stratified by 90-day modified Rankin Scale (mRS) scores into a very poor outcome group (mRS 5-6) and a non-very poor outcome group (mRS 0-4). PRIMARY OUTCOME MEASURES: The primary outcome was very poor outcomes. Data from 1242 patients were analysed for demographic, laboratory, imaging and perioperative data. RESULTS: Among the 1242 recruited patients, 318 (25.60%) exhibited very poor outcomes. In multivariate analysis, predictors of very poor outcomes were higher age (OR 1.059, 95% CI 1.043 to 1.075, p<0.001), stroke history (OR 1.993, 95% CI 1.373 to 2.888, p<0.001), coronary heart disease history(CHD;OR=1.816,95% CI 1.291-2.552,P=0.001),higher baseline National Institute of Health Stroke Scale (NIHSS; OR 1.076, 95% CI 1.054 to 1.099, p<0.001), higher neutrophil count (OR 1.078, 95% CI 1.025 to 1.134, p=0.003), lower Alberta Stroke Program Early CT Score (ASPECTS; OR 0.901, 95% CI 0.845 to 0.962, p=0.002), higher malignant cerebral oedema (MCE, OR 3.246,95% CI 2.241 to 4.713, p<0.001) and symptomatic intracranial ...