Association of reperfusion therapy in acute ischemic stroke on PROMs after one year; a registry-based case-control study

Guri Hagberg; Håkon Ihle-Hansen; Tamar Abzhandadze; Malin Reinholdsson; Adam Viktorisson; Henri Pesonen; Hege Ihle-Hansen; Katharina S Sunnerhagen

doi:10.1016/j.jns.2025.123517

Association of reperfusion therapy in acute ischemic stroke on PROMs after one year; a registry-based case-control study

J Neurol Sci. 2025 Apr 24:473:123517. doi: 10.1016/j.jns.2025.123517. Online ahead of print.

Authors

Guri Hagberg¹, Håkon Ihle-Hansen², Tamar Abzhandadze³, Malin Reinholdsson³, Adam Viktorisson⁴, Henri Pesonen⁵, Hege Ihle-Hansen⁶, Katharina S Sunnerhagen⁴

Affiliations

¹ Institute of Neuroscience and Physiology, Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Gothenburg, Sweden; Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Ullevål, Norway. Electronic address: guhagb@ous-hf.no.
² Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway; Research Department Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway.
³ Institute of Neuroscience and Physiology, Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Gothenburg, Sweden; Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁴ Institute of Neuroscience and Physiology, Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Gothenburg, Sweden; Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁵ Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
⁶ Research Department Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway; Department of Acute Medicine, Oslo Universty Hospital, Norway.

PMID: 40288140
DOI: 10.1016/j.jns.2025.123517

Abstract

Background: Patient reported outcome measures (PROMs) could expose meaningful differences but are scarcely investigated in acute stroke trials. We sought to investigate the association of reperfusion treatment after acute ischemic stroke (AIS) on PROMs, 1-year post-stroke.

Methods: A case-control study was conducted among patients admitted with AIS with PROMs collected after 1 year. PROMs included complete recovery, being able to return to life and activities, cognitive functions, depression, and fatigue. Cases were treated with reperfusion therapy (thrombolysis and/or thrombectomy) and compared to controls within the same cohort not receiving reperfusion therapy, matched for age, sex, the National Institute of Health Stroke Scale (NIHSS) at admission and premorbid modified Rankin Scale (mRS). Adjusted conditional logistic and ordinal regression models were used to investigate the association.

Results: We identified 271 reperfusion treated ischemic stroke patients (59 % men, mean ± SD age of 71 ± 14.5, mean ± SD NIHSS of 8 ± 7, 125 (46 %) with NIHSS ≤5) and 271 matched controls (59 % men, mean ± SD age of 71 ± 14.5, mean ± SD NIHSS of 7 ± 6, 147 (54 %) with NIHSS ≤5). Reperfusion treatment was associated with complete recovery (Odds ratio [OR] 2.19 [95 % CI, 1.36-3.56]), return to life and activities (OR 2.69 [95 % CI, 1.52-4.74]) and less fatigue (OR 0.37 [95 % CI, 0.17-0.80]). The results did not change in analyses restricted to NIHSS ≤5 (complete recovery (OR 1.80 [95 % CI, 1.01-3.24]) or return to prior life and activities (OR 2.57 [95 % CI, 1.16-5.7]).

Conclusions: Reperfusion treatment was associated with self-reported complete recovery, return to normal life and less fatigue 1-year post-stroke.

Keywords: Case-control study; Ischemic stroke; Long-term follow-up; Patient reported outcome measures; Thrombectomy; Thrombolysis.