Journal Article

DZNE-2025-01346

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Patterns and predictors of delayed functional independence and dependence after thrombectomy in large vessel occlusion stroke: A multicenter analysis.

von Danwitz, N. M. (First author)DZNE* ; Bode, F. J.Extern* ; Samani, O. S.DZNE* ; Asperger, H.DZNE* ; Ebrahimi, T.DZNE* ; Kaesmacher, J. ; Layer, J.DZNE* ; Lehnen, N. ; Nitsch, L. ; Meissner, J. N. ; Odensass, S. ; Stösser, S.Extern* ; Thielscher, C.DZNE* ; Zidan, M. ; Dorn, F. ; Petzold, G. C.DZNE* ; Weller, J. M.

2025
Sage Publishing London

This record in other databases:    

Please use a persistent id in citations: doi:10.1177/23969873251342048

Abstract: Predicting functional outcomes following endovascular treatment (EVT) for large-vessel occlusion stroke (LVOS) is challenging. Some patients achieve functional independence (modified Rankin Scale (mRS) 0 -2) at 90 days despite being dependent at discharge, termed delayed functional independence (DFI), while others lose independence after discharge, termed delayed functional dependence (DFD). This study explores patterns and predictors of DFI and DFD in LVOS patients undergoing EVT.We analyzed anterior circulation LVOS patients from the prospective multicenter German Stroke Registry. Multivariable logistic regression models identified independent predictors of DFI and DFD.Of 5909 patients, 2346 were independent at discharge, with 16.1% experiencing DFD at 90 days. DFD was associated with older age (median 78 vs 69 years, p < 0.001), female sex (61.4% vs 46.1%, p < 0.001), and greater stroke severity. Variables associated with DFD in multivariable analysis included older age, female sex, higher premorbid and discharge mRS, higher NIHSS at discharge, and absence of IV thrombolysis. Of 3563 patients dependent at discharge, 20.6% achieved DFI. DFI patients were younger (median 71 vs 77 years, p < 0.001), less likely female (38.7% vs 52.6%, p < 0.001) and had lower admission NIHSS, better pre-stroke functional status, higher ASPECTS and more frequent successful recanalization. Variables associated with DFI in multivariable analysis included younger age, male sex, better pre-stroke functional status, lower stroke severity and successful recanalization.Both DFD and DFI are frequent in clinical practice, with higher DFD and lower DFI rates in women, which warrants further investigation. Understanding these predictors can enhance individualized patient counseling and management strategies.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Male (MeSH) ; Aged (MeSH) ; Thrombectomy: methods (MeSH) ; Aged, 80 and over (MeSH) ; Middle Aged (MeSH) ; Treatment Outcome (MeSH) ; Recovery of Function (MeSH) ; Registries (MeSH) ; Ischemic Stroke: surgery (MeSH) ; Functional Status (MeSH) ; Prospective Studies (MeSH) ; Endovascular Procedures (MeSH) ; Stroke: surgery (MeSH) ; Germany (MeSH) ; Stroke ; delayed dependence ; endovascular treatment ; functional dependence ; functional independence ; mechanical thrombectomy ; outcome

---

Contributing Institute(s):

1. Clinical Research Platform (CRP) (Clinical Research Platform (CRP))
2. Vascular Neurology (AG Petzold)
3. Clinical Single Cell Omics (CSCO) / Systems Medicine (AG Schultze)
4. Patient Studies (Bonn) (Patient Studies (Bonn))

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)
2. 354 - Disease Prevention and Healthy Aging (POF4-354) (POF4-354)

Appears in the scientific report 2025

---

Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Essential Science Indicators ; IF >= 5 ; JCR ; National-Konsortium ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

---