{
  "abstract": "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 A 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 haemorrhage (sICH, OR 3.97, 95% CI 2.569 to 6.169, p<0.001) and receiving intravenous thrombolysis (IVT, OR = 0.600,95% CI 0.431-0.830, P =0.002) . The predictive model demonstrated a certain degree of accuracy (area under the curve 0.839, 95% CI 0.813 to 0.864).Conclusions The very poor outcomes were associated with advanced age, CHD history, stroke history, high NIHSS score, high neutrophil count, low ASPECTS and presence of MCE and sICH, while receiving intravenous thrombolysis was a protective factor. These poor outcome predictors might play a crucial role in informing clinical decision-making.Trial registration number ClinicalTrials.gov ( NCT06290076); pre-results.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Qilu Hosipital of ShanDong University Dezhou Hosipital, Dezhou, China",
        "Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Zhixia Li"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, Shandong, China"
      ],
      "name": "Jiheng Hao"
    },
    {
      "affiliations": [
        "Department of Neurology, Nanyang Central Hospital, Nanyang, China"
      ],
      "name": "Changming Wen"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Affiliated Cardiovascular Hospital of Shanxi Medical University and Shanxi Cardiovascular Hospital (Institute), Taiyuan, China"
      ],
      "name": "Tao Cheng"
    },
    {
      "affiliations": [
        "Department of Neurology, Jinan Hospital of Xuanwu Hospital, Shandong First Medical University, Jinan, China"
      ],
      "name": "Yanxin Zhao"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China",
        "China International Neuroscience Institute (China-INI), Beijing, China"
      ],
      "name": "Xuesong Bai"
    },
    {
      "affiliations": [
        "University of Pittsburgh Medical Center Stroke Institute, Department of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Xiaofan Guo"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China",
        "China International Neuroscience Institute (China-INI), Beijing, China",
        "Department of Neurosurgery, Jinan University Affiliated Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China"
      ],
      "name": "Wenbo Cao"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China",
        "China International Neuroscience Institute (China-INI), Beijing, China"
      ],
      "name": "Tianhua Li"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Kunming Medical University, Kunming, China"
      ],
      "name": "Xiao-li Min"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China",
        "Department of Neurosurgerynt, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical University, National Center for Neurological Disorders, Beijing, China"
      ],
      "name": "Liqun Jiao"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, Shandong, China"
      ],
      "name": "Liyong Zhang"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China",
        "China International Neuroscience Institute (China-INI), Beijing, China"
      ],
      "name": "Bin Yang"
    }
  ],
  "title": "Predictive factors for very poor outcomes after endovascular thrombectomy in anterior circulation large vessel occlusion: a multicentre retrospective study in China",
  "uid": "f626f503-5601-57d5-bfc3-3c129f069368"
}