Reader Response: Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke
QianFeng, Neurologist, Department of Neurology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou City, China
HuaZhou, Neurologist, Department of Neurology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou City, China
ZhongZhao, Neurologist, Department of Neurology, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou City, China
Submitted December 16, 2021
We read with interest the article by de Havenon et al.1 In this study, the authors performed a post-hoc analysis in patients with thrombectomy to examine the relationship between pre-morbid disability and outcome of endovascular therapy by using modified Rankin Scale (mRS). They found that patients without premorbid disability were more likely to accumulate further disability than those patients with premorbid disability, but patients with premorbid disability had a higher mortality. The Modified Rankin Scale is used to evaluate the neurological recovery of stroke patients,2 and is also widely used in clinical practice including cerebral infarction,2 cerebral hemorrhage,3 and cardiac arrest.4 However, the reasons for patients’ pre-stroke disability and death after 90-day follow-up were unclear. Epidemiological studies show that primary causes of disability vary across different age populations. Ischemic heart diseases and stroke are the primary causes of disability in 50-74-year-olds and those who are 75 years and over, respectively.5 In this study, it was unclear whether ischemic heart diseases or other non-cerebrovascular causes were the main cause of pre-stroke disability and death. Additional investigation should identify the indications and contraindications for endovascular therapy in patients with anterior circulation occlusion, which will be benefit treatment of stroke patients.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
de Havenon A, Castonguay A, Nogueira R, et al. Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke. Neurology. 2021;97(19): e1914-e1919.
Broderick JP,Adeoye O, Elm J, Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials. Stroke.2017;48(7): 2007-2012.
Roquer J, et al.Sex-related differences in primary intracerebral hemorrhage. Neurology.2016; 87(3): 257-262.
Tong JT, Eyngorn I, Mlynash M, Albers GW, Hirsch KG..Functional Neurologic Outcomes Change Over the First 6 Months After Cardiac Arrest. Crit Care Med.2016;44(12):e1202-e1207.
GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet.2020;396(10258):1204-1222.
We read with interest the article by de Havenon et al.1 In this study, the authors performed a post-hoc analysis in patients with thrombectomy to examine the relationship between pre-morbid disability and outcome of endovascular therapy by using modified Rankin Scale (mRS). They found that patients without premorbid disability were more likely to accumulate further disability than those patients with premorbid disability, but patients with premorbid disability had a higher mortality. The Modified Rankin Scale is used to evaluate the neurological recovery of stroke patients,2 and is also widely used in clinical practice including cerebral infarction,2 cerebral hemorrhage,3 and cardiac arrest.4 However, the reasons for patients’ pre-stroke disability and death after 90-day follow-up were unclear. Epidemiological studies show that primary causes of disability vary across different age populations. Ischemic heart diseases and stroke are the primary causes of disability in 50-74-year-olds and those who are 75 years and over, respectively.5 In this study, it was unclear whether ischemic heart diseases or other non-cerebrovascular causes were the main cause of pre-stroke disability and death. Additional investigation should identify the indications and contraindications for endovascular therapy in patients with anterior circulation occlusion, which will be benefit treatment of stroke patients.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
References