Anterior circulation large vessel occlusion stroke in Saudi Arabia: Prevalence,predictors, and outcome |
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| Institution: | 2. College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;3. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia;4. Unaizah College of Medicine, Qassim University, Qassim, Saudi Arabia;5. College of Medicine, Almaarefa University, Riyadh, Saudi Arabia;2. PGY-4, Neurology Cleveland Clinic Florida;3. Department of Neurology Cleveland Clinic Florida;4. Department of Pulmonary and Critical Care Medicine Cleveland Clinic Florida;2. Department of Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany;3. Division of Infectious Diseases, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany;4. Institute of Diagnostic and Interventional Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany;2. Medical University of South Carolina, United States;3. University of Ibadan, Nigeria;4. University of California San Francisco, United States;2. Area Diagnostica per Immagini, UOC Radiologia e Neuroradiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;2. Post-Graduate Program in Cardiology and Cardiovascular Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;3. Neurology Division, Hospital de Clínicas de Porto Alegre, Brazil;2. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;3. Department of Pathology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan;4. Department of Radiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan;5. Department of Neurology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan;6. Midorii Neurosurgical Hospital, Hiroshima, Japan |
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| Abstract: | ObjectiveAnterior circulation Large Vessel Occlusion (LVO) stroke comes with significant morbidity and mortality. With the advent of endovascular interventions, its management has revolutionized. For health authorities to build systems and allocate resources, its burden, predictors, and outcome must be determined.MethodsIn a single tertiary care center, we retrospectively collected data from 1495 ischemic stroke patients to determine anterior circulation LVO prevalence, predictors, and outcome. Patients must have radiologically proven ischemic stroke within 24 hours before arrival at the emergency department. Anterior circulation LVO related stroke was defined as evidence of new anterior circulation infarct detected on neuroimaging, and vascular imaging confirming anterior circulation Large Vessel Occlusion. Data on demographics, vascular risk factors, treatment with reperfusion therapy, modified Rankin Scale (mRS) at admission, National Institute of Health Stroke Scale (NIHSS) at admission, length of stay (LOS) in days, and in-hospital comorbidities and death were collected. Regression analysis was done to determine the predictors and outcomes of anterior circulation LVO ischemic strokes.ResultsWe found anterior circulation LVO in 27.8% (95 % CI 25.5–30.0) of all ischemic stroke patients. Atrial fibrillation and admission National Institute of Health Stroke Scale (NIHSS) were the strongest predictors of LVO OR 2.33, P = 0.0011 and OR 1.17, P < 0.0001] respectively. Occurrence of LVO was associated with worse disability score (mRS ≥ 3) 47.22 vs. 19.81% (P = 0.0073)], longer hospitalization in days Median 9.0 vs. 3.0, IQR (14.0 vs. 5.0) P = 0.0432)], and was more likely to results in patient admission to intensive care unit Mean 17.59 vs. 3.70 % (P = 0.0002)].ConclusionStroke with large vessel occlusion in Saudi Arabia is not uncommon. Its burden and outcome deserve national attention, as effective treatment is now readily available. |
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