Failed recanalization mediates the association of women with poor outcomes after thrombectomy: a single-center experience
Background Whether thrombectomy benefits differ according to sex remains debatable. We aimed to investigate whether there was a difference in stroke outcomes between men and women treated with thrombectomy. Methods We studied 173 patients with anterior circulation strokes. Failed recanalization was...
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| Format: | Article |
| Language: | English |
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The Korean Neurocritical Care Society
2022-12-01
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| Series: | Journal of Neurocritical Care |
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| Online Access: | http://www.e-jnc.org/upload/pdf/jnc-220054.pdf |
| _version_ | 1827942543466168320 |
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| author | Seung-Jae Lee Tae-Kyeong Lee Ji Eun Moon |
| author_facet | Seung-Jae Lee Tae-Kyeong Lee Ji Eun Moon |
| author_sort | Seung-Jae Lee |
| collection | DOAJ |
| description | Background Whether thrombectomy benefits differ according to sex remains debatable. We aimed to investigate whether there was a difference in stroke outcomes between men and women treated with thrombectomy. Methods We studied 173 patients with anterior circulation strokes. Failed recanalization was defined as thrombolysis in cerebral infarction grade 0-2a. Scores >2 on the modified Rankin Scale at 3 months were regarded as poor outcomes. To prove that failed recanalization mediated the association between sex differences and functional outcome, the four steps of the reasoning process adapted from Baron and Kenny’s causal-steps approach were tested. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. Results This study included 76 women and 97 men. Women were older and presented with atrial fibrillation more frequently than men. Female sex was independently associated with failed recanalization (aOR, 2.729; 95% CI, 1.334–5.582), which was an independent predictor of poor outcomes (aOR, 4.630; 95% CI, 1.882–11.389). Women were associated with poor outcomes in the analysis adjusted for confounders, except for failed recanalization (aOR, 2.285; 95% CI, 1.064–4.906). However, the association became insignificant in the additional analysis adjusted for failed recanalization (aOR, 1.670; 95% CI, 0.738–3.784). The indirect effect between female sex and poor outcomes via failed recanalization was statistically significant (aOR, 1.038; 95% CI, 1.010–1.127). Conclusion Our study showed that failed recanalization mediated the association between women and poor outcomes after thrombectomy. Nonetheless, this might be explained by chance given our limited study population. |
| first_indexed | 2024-03-13T10:01:18Z |
| format | Article |
| id | doaj.art-742971c5bb75493ab811b25144f443f0 |
| institution | Directory Open Access Journal |
| issn | 2005-0348 2508-1349 |
| language | English |
| last_indexed | 2024-03-13T10:01:18Z |
| publishDate | 2022-12-01 |
| publisher | The Korean Neurocritical Care Society |
| record_format | Article |
| series | Journal of Neurocritical Care |
| spelling | doaj.art-742971c5bb75493ab811b25144f443f02023-05-23T05:34:57ZengThe Korean Neurocritical Care SocietyJournal of Neurocritical Care2005-03482508-13492022-12-0115210411210.18700/jnc.220054369Failed recanalization mediates the association of women with poor outcomes after thrombectomy: a single-center experienceSeung-Jae Lee0Tae-Kyeong Lee1Ji Eun Moon2 Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, KoreaBackground Whether thrombectomy benefits differ according to sex remains debatable. We aimed to investigate whether there was a difference in stroke outcomes between men and women treated with thrombectomy. Methods We studied 173 patients with anterior circulation strokes. Failed recanalization was defined as thrombolysis in cerebral infarction grade 0-2a. Scores >2 on the modified Rankin Scale at 3 months were regarded as poor outcomes. To prove that failed recanalization mediated the association between sex differences and functional outcome, the four steps of the reasoning process adapted from Baron and Kenny’s causal-steps approach were tested. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. Results This study included 76 women and 97 men. Women were older and presented with atrial fibrillation more frequently than men. Female sex was independently associated with failed recanalization (aOR, 2.729; 95% CI, 1.334–5.582), which was an independent predictor of poor outcomes (aOR, 4.630; 95% CI, 1.882–11.389). Women were associated with poor outcomes in the analysis adjusted for confounders, except for failed recanalization (aOR, 2.285; 95% CI, 1.064–4.906). However, the association became insignificant in the additional analysis adjusted for failed recanalization (aOR, 1.670; 95% CI, 0.738–3.784). The indirect effect between female sex and poor outcomes via failed recanalization was statistically significant (aOR, 1.038; 95% CI, 1.010–1.127). Conclusion Our study showed that failed recanalization mediated the association between women and poor outcomes after thrombectomy. Nonetheless, this might be explained by chance given our limited study population.http://www.e-jnc.org/upload/pdf/jnc-220054.pdfsexstrokeoutcomethrombectomy |
| spellingShingle | Seung-Jae Lee Tae-Kyeong Lee Ji Eun Moon Failed recanalization mediates the association of women with poor outcomes after thrombectomy: a single-center experience Journal of Neurocritical Care sex stroke outcome thrombectomy |
| title | Failed recanalization mediates the association of women with poor outcomes after thrombectomy: a single-center experience |
| title_full | Failed recanalization mediates the association of women with poor outcomes after thrombectomy: a single-center experience |
| title_fullStr | Failed recanalization mediates the association of women with poor outcomes after thrombectomy: a single-center experience |
| title_full_unstemmed | Failed recanalization mediates the association of women with poor outcomes after thrombectomy: a single-center experience |
| title_short | Failed recanalization mediates the association of women with poor outcomes after thrombectomy: a single-center experience |
| title_sort | failed recanalization mediates the association of women with poor outcomes after thrombectomy a single center experience |
| topic | sex stroke outcome thrombectomy |
| url | http://www.e-jnc.org/upload/pdf/jnc-220054.pdf |
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