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Further investigations: Very-Long-term FU EVT (Difference of very-longterm…
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Mortality
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Exclusion of short-term mortality ? At 3-months FU ?
- As done in „Life Expectancy after Stroke Based On Age, Sex, and Rankin Grade of Disability: A Synthesis“ –> rather a study limitation according to paper.
- Also done in „Long‐term outcome changes after mechanical thrombectomy for anterior circulation acute ischemic stroke“ Fuhrer et al.: Adjustments were made by excluding patients who deceased (mRS 6) between acute MT treatment and the 3-month interview as they would not be able to show changes until the follow-up
That there are significant differences in life expectancies between the grades demonstrates the importance of rehabilitation
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Recanalisation
- litterature review compares TICI2b with TICI 3.
- adjustment for collarerals
- adjustment for number of passes.
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Early Prediction of One-Year Mortality in Ischemic and Haemorrhagic Stroke, Liljehult et al., 2020
- The aim of this study was to identify potential predictors of 1-year mortality in stroke victims and construct a simple and valid prediction model.
- Multiple logistic regression analysis with backwards selection was used to identify predictors and construction of a prediction model.
- Results: Within the first year 186 patients died (18.0%) and 4 (0.4%) were lost to follow-up. Age (OR 1.08), gender (OR 2.19), stroke severity (OR 1.03), Early Warning Score (OR 1.17), Performance Status (ECOG) (OR 1.94), Body Mass Index (OR 0.91), the Charlton’s Comorbidity Index (OR 1.17), and urinary problems (OR 2.55) were found to be independent predictors of 1-year mortality. A model including age, stroke severity, Early Warning Score, and Performance Status was found to be valid (AUC 86.5 %, Brier Score 9.03).
Further research is required to determine if functional Outcome (mRS at 3-month) is a prognostic factor for long-term mortality.
Use of life tables for descriptives statistics:
- Life Tables is a descriptive procedure for examining the distribution of time-to-event variables.
- The basic idea of life tables is to subdivide the period of observation into smaller time intervals. Then the probability from each of the intervals are estimated.
- Analyze > Survival > Life Tables
Use of Kaplan-Meier procedure
- A method of estimating time-to-event models in the presence of censored cases.
- Censored cases (right-censored cases) are those for which the event of interest has not yet happened.
- Probabilities for the event of interest should depend only on time after the initial event without covariates effects.
Mortality and ASPECT: measurement of semi-quantitative (ASPECTS) and quantitative (core volume) imaging modalities.
Statistics VLTFU
Variable-comparison -> use of statistical test.
- mRS: Evolution LTFU vs. VLTFU
-> H0 -> improvement of mRS across time.
-> mRS LTFU vs. mRS VLTFU.
-> Descriptive statistics, Paired Samples t-Tests ?
-> Descriptive statistics
- Within vs beyond guidelines
-> H0 -> worse outcomes for patients treated beyond guidelines.
-> Independant variante: indications within vs. beyond guidelines.
-> Dependant variante: mRS-outcome.
-> Test the equivalence between two samples: Equivalence test (TOST)
or
-> Compare two observed means (independent samples): t-test on two independent samples or Mann-Whitney's test
Mortality and life expectancy
- Regression Analysis to investigate trend in mortality and espected life-expectancy after EVT.
- Compare mortality after E
Assessment of quality of life
- QoL -> scores and place of residence.
- Only use of descriptive statistics ? Or possibility to compare with Beyond ? No control group ...
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