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  • Springer Science and Business Media LLC  (2)
  • Flottmann, Fabian  (2)
  • 1
    Online Resource
    Online Resource
    Sex Differences in Outcome After Thrombectomy for Acute Ischemic Stroke are Explained by Confounding Factors
    Springer Science and Business Media LLC ; 2021
    In:  Clinical Neuroradiology Vol. 31, No. 4 ( 2021-12), p. 1101-1109
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    In: Clinical Neuroradiology, Springer Science and Business Media LLC, Vol. 31, No. 4 ( 2021-12), p. 1101-1109
    Abstract: The aim of this study was to analyze sex differences in outcome after thrombectomy for acute ischemic stroke in clinical practice in a large prospective multicenter registry. Methods Data of consecutive stroke patients treated with thrombectomy (June 2015–April 2018) derived from an industry-independent registry (German Stroke Registry–Endovascular Treatment) were prospectively analyzed. Multivariable binary logistic regression analyses were applied to determine whether sex is a predictor of functional independence outcome (defined as a modified Rankin scale [mRS] 0–2) 90 days after stroke. Results In total, 2316 patients were included in the analysis, 1170 (50.5%) were female and 1146 (49.5%) were male. Women were older (median age 78 vs. 72 years; p   〈  0.001) and more frequently had a prestroke functional impairment defined by mRS 〉 1 (24.8% vs. 14.1%; p   〈  0.001). In unadjusted analyses, independent outcome at 90 days was less frequent in women (33.2%) than men (40.6%; p   〈  0.001). Likewise, mortality was higher in women than in men (30.7% vs. 26.4%; p  = 0.024). In adjusted regression analyses, however, sex was not associated with outcome. Lower age, a lower baseline National Institutes of Health Stroke Scale score, a higher Alberta Stroke Program Early CT score, prestroke functional independence, successful reperfusion, and concomitant intravenous thrombolysis therapy predicted independent outcome. Conclusion Women showed a worse functional outcome after thrombectomy for acute ischemic stroke in clinical practice; however, after adjustment for crucial confounders sex was not a predictor of outcome. The difference in outcome thus appears to result from differences in confounding factors such as age and prestroke functional status.
    Type of Medium: Online Resource
    ISSN: 1869-1439 , 1869-1447
    URL: Article
    DOI: 10.1007/s00062-020-00983-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2232347-8
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  • 2
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    Side matters: differences in functional outcome and quality of life after thrombectomy in left and right hemispheric stroke
    Springer Science and Business Media LLC ; 2022
    In:  Neurological Research and Practice Vol. 4, No. 1 ( 2022-11-21)
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    In: Neurological Research and Practice, Springer Science and Business Media LLC, Vol. 4, No. 1 ( 2022-11-21)
    Abstract: Patients with a left (LHS) or right hemispheric stroke (RHS) differ in terms of clinical symptoms due to lateralization of specific cortical functions. Studies on functional outcome after stroke and endovascular thrombectomy (EVT) comparing both hemispheres showed conflicting results so far. The impact of stroke laterality on patient-reported health-related quality of life (HRQoL) after EVT has not yet been adequately addressed and still remains unclear. Methods Consecutive stroke thrombectomy patients, derived from a multi-center, prospective registry (German Stroke Registry) between June 2015 and December 2019, were included in this study. At 90 days, outcome after EVT was assessed by the modified Rankin scale (mRS) and HRQoL using the European QoL-five dimensions questionnaire utility-index (EQ-5D-I; higher values indicate better HRQoL) in patients with LHS and RHS. Adjusted regression analysis was applied to evaluate the influence of stroke laterality on outcome after EVT. Results In total, 5683 patients were analyzed. Of these, 2953 patients (52.8%) had LHS and 2637 (47.2%) RHS. LHS patients had a higher baseline NIHSS (16 vs. 13, p  〈  0.001) and a higher ASPECTS (9 vs. 8, p  〈  0.001) compared to RHS patients. Among survivors, patients with LHS less frequently had a self-reported affected mobility (p = 0.037), suffered less often from pain (p = 0.04) and anxiety/depression (p = 0.032) three months after EVT. After adjusting for confounders (age, sex, baseline NIHSS), LHS was associated with a better HRQoL (ß coefficient 0.04, CI 95% 0.017–0.063; p = 0.001), and better functional outcome assessed by lower values on the mRS (ß coefficient − 0.109, CI 95% − 0.217–0.000; p = 0.049). Conclusions Ninety days after EVT, LHS patients have a better functional outcome and HRQoL. Patients with RHS should be actively assessed and treated for pain, anxiety and depression to improve their HRQoL after EVT.
    Type of Medium: Online Resource
    ISSN: 2524-3489
    URL: Article
    DOI: 10.1186/s42466-022-00223-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2947493-0
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