{
  "abstract": "Background/Aim Endovascular stroke therapy (EVT) improves functional outcome and reduces mortality in patients with large vessel occlusion. However, data on risk factors for early mortality after EVT are scarce. We investigated the predictive value of clinical information already available on the day of hospital admission on early mortality following EVT.Methods We analyzed data from the nationwide Austrian Stroke Unit Registry (ASUR) covering consecutive stroke patients that had received EVT between 2013 and 2023. We used multivariable regularized regression analysis to identify factors associated with early mortality (defined as deceased within 7 days post-stroke). We further tested the accuracy of a modified version of the ‘Predicting Early Mortality of Ischemic Stroke’ (mPREMISE) score extending the original model by post-EVT recanalization status.Results The data showed that 5900 patients (median age: 75 years, 52.4% female) had received EVT, of whom 340 (5.7%) died within 7 days after admission. Stroke severity at admission, followed by higher age, incomplete recanalization (Thrombolysis in Cerebral Infarction scores (TICI) ≤2 a), vertebrobasilar occlusion site, diabetes, chronic heart disease, and pre-stroke disability (modified Rankin Scale >1) were independently associated with early mortality. The area under the receiver operating curve (AUC-ROC) for the mPREMISE score was 0.74 (95% confidence interval (CI), 0.71 to 0.77). Patients with a score ≥9 had a 25.8% (95% CI, 25.4 to 26.2%) risk of early mortality.Conclusion In this nationwide analysis, we identified risk factors for early mortality after EVT that can be assessed on the admission day. The mPREMISE score seems to be a reasonable tool for estimating early mortality in stroke patients undergoing EVT.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Alexander Pichler"
    },
    {
      "affiliations": [
        "Vienna University of Technology Research Unit of Computational Statistics, Vienna, Austria"
      ],
      "name": "Alexandra Posekany"
    },
    {
      "affiliations": [
        "Austrian National Public Health Institute, Vienna, Austria"
      ],
      "name": "Dominika Mikšová"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Simon Fandler-Höfler"
    },
    {
      "affiliations": [
        "Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Hannes Deutschmann"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria",
        "Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Markus Kneihsl"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria",
        "Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Stephan Seiler"
    },
    {
      "affiliations": [
        "Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria"
      ],
      "name": "Sebastian Mutzenbach"
    },
    {
      "affiliations": [
        "Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria",
        "Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria"
      ],
      "name": "Monika Killer-Oberpfalzer"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria"
      ],
      "name": "Elke R Gizewski"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria"
      ],
      "name": "Michael Knoflach"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria"
      ],
      "name": "Stefan Kiechl"
    },
    {
      "affiliations": [
        "Institute of Neuroradiology, Kepler University Hospital, Linz, Austria"
      ],
      "name": "Michael Sonnberger"
    },
    {
      "affiliations": [
        "Department of Neurology, Kepler University Hospital, Linz, Austria"
      ],
      "name": "Joachim Gruber"
    },
    {
      "affiliations": [
        "Department of Neurology, Klinikum Klagenfurt am Worthersee, Klagenfurt am Wörthersee, Austria"
      ],
      "name": "Jörg Weber"
    },
    {
      "affiliations": [
        "Institute of Diagnostic and Interventional Radiology, Klinikum Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria"
      ],
      "name": "Luca De Paoli"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Vienna, Wien, Austria"
      ],
      "name": "Stefan Greisenegger"
    },
    {
      "affiliations": [
        "Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria"
      ],
      "name": "Florian Wolf"
    },
    {
      "affiliations": [
        "Department of Neurology, Feldkirch Hospital, Feldkirch, Austria"
      ],
      "name": "Philipp Werner"
    },
    {
      "affiliations": [
        "Department of Neurology, Krankenhaus Barmherzige Brüder Eisenstadt, Eisenstadt, Austria"
      ],
      "name": "Dimitre Staykov"
    },
    {
      "affiliations": [
        "Department of Neurology, Clinic Landstrasse Clinic, Vienna, Austria"
      ],
      "name": "Peter Sommer"
    },
    {
      "affiliations": [
        "Department of Neurology, Krankenhaus der Barmherzigen Brüder Wien, Vienna, Austria"
      ],
      "name": "Marek Sykora"
    },
    {
      "affiliations": [
        "Department of Neurology, Krankenhaus der Barmherzigen Brüder Wien, Vienna, Austria"
      ],
      "name": "Julia Ferrari"
    },
    {
      "affiliations": [
        "Department of Radiology (Diagnostic and Interventional), University Hospital Tulln, Tulln, Austria"
      ],
      "name": "Christian Nasel"
    },
    {
      "affiliations": [
        "University Insitute for Neuroradiology, Paracelsus Medical University, University Hospital Salzburg, Salzburg, Austria"
      ],
      "name": "Johannes Alex Rolf Pfaff"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Christian Enzinger"
    },
    {
      "affiliations": [
        "Department of Neurology, Medical University of Graz, Graz, Austria"
      ],
      "name": "Thomas Gattringer"
    },
    {
      "affiliations": [],
      "name": "on behalf of the Austrian EVT study group"
    }
  ],
  "title": "Early mortality in patients with acute ischemic stroke after endovascular stroke therapy",
  "uid": "0d9b5c93-bb29-5a1f-b3f2-34f79be50c9a"
}