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. 2021 Jun 17;11(1):12782.
doi: 10.1038/s41598-021-92100-7.

Time-outcome relationship in acute large-vessel occlusion exists across all ages: subanalysis of RESCUE-Japan Registry 2

Kenichi Todo  1 , Shinichi Yoshimura  2 , Kazutaka Uchida  2 , Hiroshi Yamagami  3   4 , Nobuyuki Sakai  5 , Haruhiko Kishima  6 , Hideki Mochizuki  6 , Masayuki Ezura  7 , Yasushi Okada  8 , Kazuo Kitagawa  9 , Kazumi Kimura  10 , Makoto Sasaki  11 , Norio Tanahashi  12 , Kazunori Toyoda  4 , Eisuke Furui  13 , Yuji Matsumaru  14 , Kazuo Minematsu  4 , Takaya Kitano  6 , Shuhei Okazaki  6 , Tsutomu Sasaki  6 , Manabu Sakaguchi  6 , Masatoshi Takagaki  6 , Takeo Nishida  6 , Hajime Nakamura  6 , Takeshi Morimoto  15 ; RESCUE-Japan Registry 2 Investigators
Collaborators, Affiliations

Time-outcome relationship in acute large-vessel occlusion exists across all ages: subanalysis of RESCUE-Japan Registry 2

Kenichi Todo et al. Sci Rep. .

Erratum in

Abstract

Early reperfusion after endovascular thrombectomy is associated with an improved outcome in ischemic stroke patients; however, the time dependency in elderly patients remains unclear. We investigated the time-outcome relationships in different age subgroups. Of 2420 patients enrolled in the RESCUE-Japan Registry 2 study, a study based on a prospective registry of stroke patients with acute cerebral large-vessel occlusion at 46 centers, we analyzed the data of 1010 patients with successful reperfusion after endovascular therapy (mTICI of 2b or 3). In 3 age subgroups (< 70, 70 to < 80, and ≥ 80 years), the mRS scores at 90 days were analyzed according to 4 categories of onset-to-reperfusion time (< 180, 180 to < 240, 240 to < 300, and ≥ 300 min). In each age subgroup, the distributions of mRS scores were better with shorter onset-to-reperfusion times. The adjusted common odds ratios for better outcomes per 1-category delay in onset-to-reperfusion time were 0.66 (95% CI 0.55-0.80) in ages < 70 years, 0.66 (95% CI 0.56-0.79) in ages 70 to < 80 years, and 0.83 (95% CI 0.70-0.98) in ages ≥ 80 years. Early reperfusion was associated with better outcomes across all age subgroups. Achieving early successful reperfusion is important even in elderly patients.

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Conflict of interest statement

Dr. Todo reports lecturer fees from Medtronic and Stryker. Dr. Yoshimura reports research grants from Medico’s Hirata, Medtronic, and Termo and lecturer fees from Medtronic, Kaneka, and Stryker. Dr. Yamagami reports research grants from Bristol-Myers Squibb; lecturer fees from Stryker, Terumo, Medtronic, Medico’s Hirata, Johnson and Johnson, Bayer, Daiichi-Sankyo, Bristol-Myers Squibb, Boehringer Ingelheim, Takeda, and Otsuka Pharmaceutical; and membership in the advisory boards of Daiichi-Sankyo and Biomedical Solutions. Dr. Sakai reports a research grant from Termo, lecturer fees from Jimro, Johnson & Johnson, Medico’s Hirata, Medtronic, and Stryker; and membership in the advisory boards of Jimro and Medtronic. Dr. Nakamura reports lecturer fees from Johnson & Johnson, Medtronic, and Stryker. Dr. Kimura reports lecturer fees from Medtronic. Dr. Matsumaru discloses lecturer fees from Medtronic, Stryker, Terumo, Johnson & Johnson, Kaneka, and Jimro. Dr. Minematsu reports lecturer fees from Stryker and membership in the advisory board of Medico’s Hirata. The other authors report no conflicts related to the subject matter of the article.

Figures

Figure 1
Figure 1
Flowchart of the study population. ASPECTS Alberta Stroke Program Early Computed Tomography Score, mTICI modified thrombolysis in cerebral infarction, NIHSS National Institutes of Health Stroke Scale.
Figure 2
Figure 2
Distributions of the modified Rankin Scale scores at 90 days according to onset-to-reperfusion time categories in each age subgroup. In each age subgroup, onset-to-reperfusion time was associated with better outcomes.
Figure 3
Figure 3
Proportions of a good outcome and adjusted odds ratios for a good outcome according to onset-to-reperfusion time (ORT) categories in each age subgroup. The proportion of a good outcome (defined as mRS score ≤ 2) was lower in the delayed ORT categories than in those with ORT < 180 min in each age subgroup, although the association was marginal in patients aged ≥ 80 years.
See this image and copyright information in PMC

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