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@ARTICLE{vonDanwitz:282586,
      author       = {von Danwitz, Niklas M and Bode, Felix J and Samani, Omid
                      Shirvani and Asperger, Hannah and Ebrahimi, Taraneh and
                      Kaesmacher, Johannes and Layer, Julia and Lehnen, Nils and
                      Nitsch, Louisa and Meissner, Julius N and Odensass, Svenja
                      and Stösser, Sebastian and Thielscher, Christian and Zidan,
                      Mousa and Dorn, Franziska and Petzold, Gabor C and Weller,
                      Johannes M},
      title        = {{P}atterns and predictors of delayed functional
                      independence and dependence after thrombectomy in large
                      vessel occlusion stroke: {A} multicenter analysis.},
      journal      = {European stroke journal},
      volume       = {10},
      number       = {4},
      issn         = {2396-9873},
      address      = {London},
      publisher    = {Sage Publishing},
      reportid     = {DZNE-2025-01346},
      pages        = {1292 - 1299},
      year         = {2025},
      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.},
      keywords     = {Humans / Female / Male / Aged / Thrombectomy: methods /
                      Aged, 80 and over / Middle Aged / Treatment Outcome /
                      Recovery of Function / Registries / Ischemic Stroke: surgery
                      / Functional Status / Prospective Studies / Endovascular
                      Procedures / Stroke: surgery / Germany / Stroke (Other) /
                      delayed dependence (Other) / endovascular treatment (Other)
                      / functional dependence (Other) / functional independence
                      (Other) / mechanical thrombectomy (Other) / outcome (Other)},
      cin          = {Clinical Research Platform (CRP) / AG Petzold / AG Schultze
                      / Patient Studies (Bonn)},
      ddc          = {610},
      cid          = {I:(DE-2719)1011401 / I:(DE-2719)1013020 /
                      I:(DE-2719)1013038 / I:(DE-2719)1011101},
      pnm          = {353 - Clinical and Health Care Research (POF4-353) / 354 -
                      Disease Prevention and Healthy Aging (POF4-354)},
      pid          = {G:(DE-HGF)POF4-353 / G:(DE-HGF)POF4-354},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40501059},
      pmc          = {pmc:PMC12162553},
      doi          = {10.1177/23969873251342048},
      url          = {https://pub.dzne.de/record/282586},
}