Identifying the predictors of ultra early neurological improvement and its role in functional outcome after endovascular thrombectomy in acute ischemic stroke

• DOI: 10.3389/fneur.2025.1492013
• Publication Date: 2025-01-31T06:41:13Z
• Authors: Yuzheng Lai; Mohammad Mofatteh; José Fidel Baizab...; Jianfeng He; Wenhao Wu; Daohong Wang; Wenshan Yan; Jicai Ma; Sijie Zhou; Yu Sun; Yi He; Shumei Li; Hao Sun
• Keywords: Stroke

Using post-treatment methods to predict functional outcomes of acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy (EVT) is crucial in medicine. The National Institute Health Stroke Scale (NIHSS) score at 24 h has been widely used; however, there a paucity data on using earlier NIHSS scores and their association with outcome. In this study, we aimed investigate the usage 1-h time window -ultra-early neurological improvement (UENI)- as surrogate marker associated AIS treated EVT. We included 485 adults (≥18 years old) who underwent emergency EVT four academic comprehensive centers between 2020 2021. Patients pre-EVT Alberta Program Early CT Score (ASPECTS) < 6, missing follow-up data, first hour were excluded (n = 20). UENI was defined post-EVT reduction 4 points or more 0-1 within post-EVT. An mRS 0-2 after three months favorable outcome, independent walking independence 3. A total 465 our final analysis. identified 122 (26.2%) UENI. While 82.79% achieved 3-months, only 32.36% without had outcome (p 0.0001). addition, lower hospitalization costs UENI, compared No-UENI 0.003). multivariate logistic regression analysis revealed that younger age 0.0001), shorter last know normal puncture (LKNPT) 0.013), higher pre-treatment ASPECTS 0.039), modified thrombolysis cerebral infarction (mTICI) ≥2b 0.002), fewer number attempts 0.002) variables independently presence better OR: 7.999 (95% C.I. 4.415-14.495). observed about quarter Younger age, LKNPT, ASPECTS, mTICI≥2b, attempts, 3 months.