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Introduction <p>Reperfusion Treatment(RT) options for Acute Ischemic Stroke(AIS) within 24 hours include: intravenous thrombolysis(IVT)(within 4.5 hours) and/or mechanical thrombectomy(MT). The utilization of benefits in ‘real world’ scenario, especially in Lower-Middle Income countries(LMICs) is not known. We aimed to determine the ‘real-world’ utilization and effectiveness of RT. </p> Patients and methods <p>In a single-center prospective cohort study, we collected data of all AIS patients coming within 24 hours. Patients receiving RT(IVT/MT/both) and those who were ineligible and received medical management (MM) were compared for the clinical, radiological characteristics and outcomes at 90-days assessed by modified Rankin Scale (mRS). The secondary outcomes were poor outcome at 90 days(mRS 3-6), Barthel Index(BI), Caregiver Strain Index(CSI), Stroke Specific Quality of Life(SSQoL) and mortality.</p> Results <p>In the study period (January 2022-September 2023), there were 302 patients. The mean age was 55.9(SD:15.7) years and majority were males (64.9%). Patients who underwent RT (42.7%(129/302)) had similar clinical characteristics, except for lesser time to presentation, better Glasgow Coma Scale(GCS), and better median ASPECTS. IVT was given to 33.4%(101/302) and MT in 14.6%(44/302). The mRS at 90-days was significantly better in the RT group (RT:1(0;3), MM:3(1;5);P &lt;0.001). RT was an independent protective factor (OR: 0.3(0.2;0.4); p-value:&lt;0.001) for worse outcome (mRS 3-6). Other factors associated with mRS 3-6 at 90-days in multivariate analysis were high NIHSS and low ASPECTS at presentation.</p> Conclusions <p>RT is feasible and effective in LMICs. Since the burden of stroke is increasing in LMICs and mean age of stroke is lower, post-stroke disability prevention by RT is an important intervention.</p>

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Real world outcomes of reperfusion treatments in acute ischemic stroke (AIS): a prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年1月21日

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  • Pinky Chhatterpal,
  • Deepti Vibha,
  • Rajesh Kumar Singh,
  • Awadh Kishor Pandit,
  • Animesh Das,
  • Arunmozhimaran Elavarasi,
  • Rohit Bhatia,
  • Achal Kumar Srivastava,
  • Manjari Tripathi,
  • Leve Joseph,
  • Ajay Garg,
  • Shailesh B. Gaikwad

摘要

Introduction

Reperfusion Treatment(RT) options for Acute Ischemic Stroke(AIS) within 24 hours include: intravenous thrombolysis(IVT)(within 4.5 hours) and/or mechanical thrombectomy(MT). The utilization of benefits in ‘real world’ scenario, especially in Lower-Middle Income countries(LMICs) is not known. We aimed to determine the ‘real-world’ utilization and effectiveness of RT.

Patients and methods

In a single-center prospective cohort study, we collected data of all AIS patients coming within 24 hours. Patients receiving RT(IVT/MT/both) and those who were ineligible and received medical management (MM) were compared for the clinical, radiological characteristics and outcomes at 90-days assessed by modified Rankin Scale (mRS). The secondary outcomes were poor outcome at 90 days(mRS 3-6), Barthel Index(BI), Caregiver Strain Index(CSI), Stroke Specific Quality of Life(SSQoL) and mortality.

Results

In the study period (January 2022-September 2023), there were 302 patients. The mean age was 55.9(SD:15.7) years and majority were males (64.9%). Patients who underwent RT (42.7%(129/302)) had similar clinical characteristics, except for lesser time to presentation, better Glasgow Coma Scale(GCS), and better median ASPECTS. IVT was given to 33.4%(101/302) and MT in 14.6%(44/302). The mRS at 90-days was significantly better in the RT group (RT:1(0;3), MM:3(1;5);P <0.001). RT was an independent protective factor (OR: 0.3(0.2;0.4); p-value:<0.001) for worse outcome (mRS 3-6). Other factors associated with mRS 3-6 at 90-days in multivariate analysis were high NIHSS and low ASPECTS at presentation.

Conclusions

RT is feasible and effective in LMICs. Since the burden of stroke is increasing in LMICs and mean age of stroke is lower, post-stroke disability prevention by RT is an important intervention.