Scholarlink

<p>The National Institutes of Health Stroke Scale (NIHSS) at 24h is a strong predictor of long-term independence after mechanical thrombectomy for anterior circulation strokes. Its predictive value in patients with M2 segment of the middle cerebral artery (MCA-M2) occlusions, however, remains unclear. This study compares NIHSS scores at admission and 24h and early neurological improvement (ENI) definitions to predict functional outcomes at 90d for M2 occlusions. Patients with isolated MCA-M2 occlusions from the German Stroke Registry (06/2015–12/2021) were analyzed. NIHSS at admission, 24h and ENI definitions were compared for predicting excellent and good outcome, defined as modified Rankin Scale (mRS) 0-1 and 0-2. Factors impairing predictive power were identified based on multivariable logistic regression. Among 1,268 patients, 24h NIHSS showed the highest predictive accuracy, with an area under the curve (AUC) of 0.85 [95% Confidence Interval: 0.83-0.87] for both good and excellent outcomes. Optimal NIHSS thresholds were ≤8 for good and ≤7 for excellent outcomes. Advanced age, higher pre-stroke mRS, diabetes, and higher procedure passes significantly reduced prognostic accuracy. NIHSS at 24h, with thresholds of ≤8 and ≤7, is the best surrogate for predicting good and excellent functional outcomes in MCA-M2 occlusion patients. Prognostic value diminishes with advanced age, pre-stroke disability, and comorbidities such as diabetes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Early surrogates of functional outcome after thrombectomy for MCA-M2 occlusions

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月17日

查看全文
  • Helge C. Kniep,
  • Lukas Meyer,
  • Gabriel Broocks,
  • Matthias Bechstein,
  • Christian Heitkamp,
  • Laurens Winkelmeier,
  • Tobias Faizy,
  • Ludger Feyen,
  • Caspar Brekenfeld,
  • Fabian Flottmann,
  • Maximilian Schell,
  • Uta Hanning,
  • Götz Thomalla,
  • Jens Fiehler,
  • Susanne Gellißen,
  • Arno Reich,
  • Omid Nikoubashman,
  • Christian Nolte,
  • Eberhard Siebert,
  • Alexander Nave,
  • Charlotte Pietrock,
  • Gabor Petzold,
  • Franziska Dorn,
  • Jan Hendrik Schäfer,
  • Fee Keil,
  • Anna Alegiani,
  • Joachim Röther,
  • Bernd Eckert,
  • Maximilian Schell,
  • Götz Thomalla,
  • Fabian Flottmann,
  • Jens Fiehler,
  • Mario Abruscato,
  • Sven Thonke,
  • Timo Uphaus,
  • Klaus Gröschel,
  • Peter Schellinger,
  • Jan Borggrefe,
  • Lars Kellert,
  • Hanna Zimmermann,
  • Steffen Tiedt,
  • Silke Wunderlich,
  • Tobias Boeckh-Behrens,
  • Annerose Mengel,
  • Ulrike Ernemann

摘要

The National Institutes of Health Stroke Scale (NIHSS) at 24h is a strong predictor of long-term independence after mechanical thrombectomy for anterior circulation strokes. Its predictive value in patients with M2 segment of the middle cerebral artery (MCA-M2) occlusions, however, remains unclear. This study compares NIHSS scores at admission and 24h and early neurological improvement (ENI) definitions to predict functional outcomes at 90d for M2 occlusions. Patients with isolated MCA-M2 occlusions from the German Stroke Registry (06/2015–12/2021) were analyzed. NIHSS at admission, 24h and ENI definitions were compared for predicting excellent and good outcome, defined as modified Rankin Scale (mRS) 0-1 and 0-2. Factors impairing predictive power were identified based on multivariable logistic regression. Among 1,268 patients, 24h NIHSS showed the highest predictive accuracy, with an area under the curve (AUC) of 0.85 [95% Confidence Interval: 0.83-0.87] for both good and excellent outcomes. Optimal NIHSS thresholds were ≤8 for good and ≤7 for excellent outcomes. Advanced age, higher pre-stroke mRS, diabetes, and higher procedure passes significantly reduced prognostic accuracy. NIHSS at 24h, with thresholds of ≤8 and ≤7, is the best surrogate for predicting good and excellent functional outcomes in MCA-M2 occlusion patients. Prognostic value diminishes with advanced age, pre-stroke disability, and comorbidities such as diabetes.