In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. Suppl_1 ( 2020-02)
Abstract:
Information about clinical outcome and reperfusion treatment in Latin-America is not widely known. Our aim was to determine this association and other clinical factors according to the initial clinical severity in functional outcome in the population from the Latin-America Stroke Registry (LASE). Methods: Data were collected prospectively from consecutive patients admitted from January 2012-January 2017 in 20 Latin-American centers. The initial clinical severity was stratified according to the baseline NIHSS; 0-3 minor, 4-7 mild, 8-14 moderate, and ≥15 severe. Clinical outcome was defined by mRS at 3 months, dichotomized in good (0-2) and poor (3-6) groups for univariate and logistic multivariate analysis. Results: Among 5381 patients, 823(15.3%) patients received any reperfusion treatment. Of these, 84.7% received I.V. fibrinolytic, 13.2% bridging therapy, and 0.9 % primary endovascular treatment. In overall, according to initial clinical deficit by NIHSS, reperfusion treatment was associated with good outcome in mild (82.8% Vs 66.1% p=0.005), moderate (55.9 % vs. 41.6% p=0.002) and severe deficits (29.4 Vs. 18.8% p=0.002). In patients with a baseline NIHSS ≥4, multivariate analysis showed that lower NIHSS (p 〈 0.001 OR: 1,194 CI95%: 1,169-1,219), reperfusion treatment (p 〈 0.001 OR: 2.132 CI95%: 1.625-2.797) and urban setting (p 〈 0.001 OR: 2.310 CI95%: 1,702-3,134) were predictors for good outcome. In reperfusion treatment patients group, multivariate analysis showed that the presence of prior ischemic cardiopathy (p=0.009 RO: 4,304 CI95%: 1,430-12,953) and lower baseline NIHSS (p 〈 0.001 OR: 1,232 CI95%: 1,173- 1,293) were independent variables associated with a good outcome. Conclusion: In this study, the rate of reperfusion treatment in 20 stroke Latin-American centers is lower than that reported from other world regions. A significant association between reperfusion treatment and good clinical outcome was observed in mild up to severe baseline deficit in our study. The effect of ischemic cardiopathy in clinical outcome in reperfusion treated patients deserves further studies. Its association with recanalization, remote pre-conditioning ischemia and collateral circulation could be explored in our population.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.51.suppl_1.TP315
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
1467823-8
