دورية أكاديمية

Health-Related Quality of Life Among Patients With Acute Ischemic Stroke and Large Vessel Occlusion in the ESCAPE Trial

التفاصيل البيبلوغرافية
العنوان: Health-Related Quality of Life Among Patients With Acute Ischemic Stroke and Large Vessel Occlusion in the ESCAPE Trial
المؤلفون: Joundi, Raed A., Rebchuk, Alexander D., Field, Thalia S., Smith, Eric E., Goyal, Mayank, Demchuk, Andrew M., Dowlatshahi, Dar, Poppe, Alexandre Y., Williams, David J., Mandzia, Jennifer L., Buck, Brian H., Jadhav, Ashutosh P., Pikula, Aleksandra, Menon, Bijoy K., Hill, Michael D.
المصدر: Stroke ; volume 52, issue 5, page 1636-1642 ; ISSN 0039-2499 1524-4628
بيانات النشر: Ovid Technologies (Wolters Kluwer Health)
سنة النشر: 2021
الوصف: Background and Purpose: Endovascular thrombectomy (EVT) reduces 90-day disability in patients following acute ischemic stroke due to large vessel occlusion. Patient-reported outcome measures after EVT, such as health-related quality of life and specific functional domains, are less well described. Methods: We report outcomes on the EuroQol-5D (EQ-5D) from the ESCAPE (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times) randomized controlled trial at 90 days after stroke. Death was assigned an index value of 0 for EQ-5D. We used quantile regression to evaluate the association between EVT and EQ-5D index scores and logistic regression for the association between EVT and symptom-free status among 90-day survivors for each EQ-5D dimension (self-care, usual activities, mobility, pain/discomfort, and anxiety/depression), assessing for modification by age or sex and adjusting for baseline factors including stroke severity, affected hemisphere, and receipt of alteplase. Lastly, the association between severe disability at 90 days and EQ-5D was evaluated with assessment for modification by EVT, age, and sex. Results: There were 165 patients randomized to EVT and 150 patients randomized to control. Median EQ-5D was significantly higher for those who received EVT compared with best medical management (0.80 versus 0.60; P <0.001). After accounting for the greater number of deaths in the elderly, there was evidence of modification of treatment effect by age, with older age associated with a larger effect size difference in EQ-5D with EVT. Those receiving EVT had higher odds of symptom-free status in self-care, usual activities, mobility for those aged 60 to 79 years, and pain/discomfort for women, but there was no association with anxiety/depression. Severe disability at 90 days was associated with lower EQ-5D in older compared with younger individuals, and the association was not modified by EVT. Conclusions: Patients treated with EVT ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1161/strokeaha.120.033872
DOI: 10.1161/STROKEAHA.120.033872
الإتاحة: https://doi.org/10.1161/strokeaha.120.033872Test
رقم الانضمام: edsbas.7F8C86CD
قاعدة البيانات: BASE