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Outcome Predictors in Acute Basilar Artery Occlusion

Published online by Cambridge University Press:  23 September 2014

Tomáš Dornák
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Roman Herzig*
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
David Školoudík
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc Department of Neurology, University Hospital and Ostrava University, Ostrava-Poruba, Czech Republic
Daniel Šanák
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Martin Kuliha
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc Department of Neurology, University Hospital and Ostrava University, Ostrava-Poruba, Czech Republic
Martin Roubec
Affiliation:
Department of Neurology, University Hospital and Ostrava University, Ostrava-Poruba, Czech Republic
Martin Köcher
Affiliation:
Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Václav Procházka
Affiliation:
Department of Radiology, University Hospital and Ostrava University, Ostrava-Poruba, Czech Republic
Michal Král
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Tomáš Veverka
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Petr Hluštík
Affiliation:
Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
Jana Zapletalová
Affiliation:
Department of Medical Biophysics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacký University, Olomouc
Miroslav Herman
Affiliation:
Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc
*Corresponding
*Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, I. P. Pavlova 6, CZ-775 20 Olomouc, Czech Republic. Email: herzig.roman@seznam.cz
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Abstract

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Objective:

To identify predictors of good outcome in acute basilar artery occlusion (BAO).

Background:

Acute ischemic stroke (AIS) caused by BAO is often associated with a severe and persistent neurological deficit and a high mortality rate.

Methods:

The set consisted of 70 consecutive AIS patients (51 males; mean age 64.5±14.5 years) with BAO. The role of the following factors was assessed: baseline characteristics, stroke risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, estimated time to therapy procedure initiation, treatment method, recanalization rate, change in neurological deficit, post-treatment imaging findings. 30- and 90-day outcome was assessed using the modified Rankin scale with a good outcome defined as a score of 0–3.

Results:

The following statistically significant differences were found between patients with good versus poor outcomes: mean age (54.2 vs. 68.9 years; p=0.0001), presence of arterial hypertension (52.4% vs. 83.7%; p=0.015), diabetes mellitus (9.5% vs. 55.1%; p=0.0004) and severe stroke (14.3% vs. 65.3%; p=0.0002), neurological deficit at time of treatment (14.0 vs. 24.0 median of National Institutes of Health Stroke Scale [NIHSS] points; p=0.001), successful recanalization (90.0% vs. 54.2%; p=0.005), change in neurological deficit (12.0 vs. 1.0 median difference of NIHSS points; p=0.005). Stepwise binary logistic regression analysis identified age (OR=0.932, 95% CI=0.882–0.984; p=0.012), presence of diabetes mellitus (OR=0.105, 95% CI=0.018–0.618; p=0.013) and severe stroke (OR=0.071, 95% CI=0.013–0.383; p=0.002) as significant independent negative predictors of good outcome.

Conclusions:

In the present study, higher age, presence of diabetes mellitus and severe stroke were identified as significant independent negative predictors of good outcome.

Type
Original Article
Copyright
Copyright © The Canadian Journal of Neurological 2014

References

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