Influencing factors for prognoses of patients with acute basilar artery occlusion after bridging therapy / 中华神经医学杂志

ABSTRACT

Objective:To investigate the influencing factors for prognoses of patients with acute basilar artery occlusion (BAO) receiving bridging therapy (intravenous thrombolysis [IVT] combined with endovascular treatment [EVT]).Methods:The clinical and imaging data of 404 patients with acute BAO accepted bridging therapy were collected from Endovascular Treatment for acute Basilar Artery Occlusion (ATTENTION) database. The prognoses of these patients were evaluated by modified Rankin Scale (mRS) 90 d after treatment. The differences of clinical and imaging data between patients with good prognosis and poor prognosis were compared, and the independent influencing factors for prognoses were analyzed by multivariate Logistic regression.Results:Among 404 patients with acute BAO, 156 (39%) had good prognosis and 248 (61%) had poor prognosis. Compared with the good prognosis group, the poor prognosis group had significantly higher proportions of patients older than 65 years, patients with NIHSS scores>20 on admission, and patients with thrombectomy frequency>1, significantly lower proportion of patients with successful vascular recanalization, and significantly different distribution of occlusive sites ( P<0.05). Multivariate Logistic regression analysis showed that NIHSS scores on admission>20 ( OR=0.510, 95%CI 0.331-0.786, P=0.002), and occlusion site at the distal basilar artery ( OR=2.241, 95%CI 1.357-3.702, P=0.002), thrombectomy frequency>1 ( OR=0.523, 95%CI 0.339-0.807, P=0.003) and successful vascular recanalization ( OR=2.022, 95%CI 1.032-3.961, P=0.040) were independent influencing factors for good prognosis of these patients. Conclusion:Acute BAO patients with NIHSS scores>20 on admission, thrombectomy frequency>1, non-distal BAO occlusion, and unsuccessful recanalization have poor prognosis after bridging therapy.