Comorbidities Related to Clinical Outcomes in Patients With Acute Ischemic Stroke Undergoing Mechanical Thrombectomy: Review of Literature and Experience at a Single Comprehensive Stroke Center

Ochsner J. 2019 Spring;19(1):13-16. doi: 10.31486/toj.18.0108.


Background: Recent clinical trials have shown mechanical thrombectomy (MT) to have clinical benefit for patients with acute ischemic stroke. The purpose of this study was to identify comorbid conditions that correlate with functional nonindependence in patients with acute ischemic stroke who underwent MT at a single comprehensive stroke center. Methods: Patients who had multiphase computed tomography angiography (MCTA) and subsequently underwent MT were included in this study. The modified Rankin Scale (mRS) scores at baseline (prestroke) and at 90 days were established by reviewing patients' histories and medical record documentation. Comorbid conditions were obtained from electronic medical records. Multivariate analysis was performed for body mass index, chronic hypertension, diabetes, hemoglobin A1c, peripheral artery disease, and hyperlipidemia to determine the impact of comorbidities on functional outcome. Age was analyzed using linear regression. Functional independence was defined as an mRS score of 0-2, and functional nonindependence was defined as an mRS score >2. Results: During the study period, 721 patients underwent MCTA, and 134 patients were included for MT. Patients with chronic hypertension and peripheral artery disease showed a statistically significant association with functional nonindependence at 90 days (P=0.005 and P=0.0125, respectively). Younger age at presentation was correlated with functional nonindependence using linear regression (P=0.0001). Conclusion: Hypertension, peripheral artery disease, and younger age at presentation are correlated with poor functional outcome in patients with acute ischemic stroke undergoing MT.

Keywords: Comorbidity; critical care outcomes; hypertension; peripheral arterial disease; stroke; thrombectomy.