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Pre-stroke cognitive impairment in acute ischemic stroke patients predicts poor functional outcome after mechanical thrombectomy

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Abstract

Objective

Several studies have investigated the predictors of functional outcome in patients with ischemic stroke after mechanical thrombectomy (MT). However, it is not clear whether pre-stroke cognitive (PSC) impairment is associated with the functional outcome of patients treated with MT.

Methods

We enrolled 113 patients treated with MT from December 2016 to November 2018. PSC was evaluated using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Poor outcome was defined as a modified Rankin Scale score of 3–6. We compared the clinical characteristics between the groups with poor outcome (n = 61) and good outcome (n = 52) to determine if PSC could be a predictor of poor outcome.

Results

IQCODE was significantly higher in the group with poor outcome than good outcome (3.34 vs. 3.13, P = 0.017). Moreover, the following metrics differed between those two groups: age (75.9 vs. 71.6 years old, P = 0.010), the percentage of females (39.9% vs. 17.3%, P = 0.009), the percentage with hypertension (72.1% vs. 44.2%, P = 0.003), National Institutes of Health Stroke Scale (NIHSS) score on admission (20 vs. 11, P < 0.001), and no successful recanalization (24.5% vs. 7.7%; P = 0.025). Multivariable logistic regression analysis demonstrated that PSC (OR: 5.59; 95% CI: 1.55–23.47), history of hypertension (OR: 3.33; 95% CI: 1.29–9.11), no successful recanalization (OR: 5.51; 95% CI: 1.49–25.03), and NIHSS score on admission (OR: 1.14; 95% CI: 1.07–1.22) were associated with poor outcome 3 months after stroke onset.

Conclusions

PSC was significantly and independently associated with poor functional outcome in patients treated with MT.

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Data availability

The datasets analyzed during the current research available from the corresponding author on reasonable request.

Code availability

Not applicable

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Acknowledgements

We thank Shizuka Abe, Asami Takeuchi, and Chie Ushiki for their assistance with database registration.

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Authors and Affiliations

  1. Department of Neurology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Takuya Kanamaru, Satoshi Suda, Kanako Muraga, Akiko Ishiwata, Junya Aoki, Kentaro Suzuki, Yuki Sakamoto, Takehiro Katano, Takuya Nishimura, Yasuhiro Nishiyama & Kazumi Kimura

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  1. Takuya Kanamaru
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Contributions

Takuya Kanamaru: Data curation, formal analysis, investigation, visualization, and writing- original draft. Satoshi Suda: Conceptualization, data curation, methodology, and project administration. Kanako Muraga and Akiko Ishiwata: Conceptualization, data curation, and investigation. Junya Aoki, Kentaro Suzuki, Yuki Sakamoto, Takehiro Katano, and Takuya Nishimura: Data curation and investigation. Yasuhiro Nishiyama and Kazumi Kimura: Conceptualization, supervision. All authors: Writing - reviewing and editing.

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Correspondence to Takuya Kanamaru.

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This study was approved by the ethics committee of Nippon Medical School and conformed to the tenets of the Declaration of Helsinki.

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Kanamaru, T., Suda, S., Muraga, K. et al. Pre-stroke cognitive impairment in acute ischemic stroke patients predicts poor functional outcome after mechanical thrombectomy. Neurol Sci 42, 4629–4635 (2021). https://doi.org/10.1007/s10072-021-05158-6

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