In a retrospective cohort of 144 AIS patients after mechanical thrombectomy, pre-existing hypertension, lower baseline ASPECTS, elevated NLR, longer onset-to-reperfusion time, and delayed start of rehabilitation were independent predictors of poor 90-day functional outcome (mRS >2), and the combined model showed excellent discrimination (AUC 0.964).
Five independent predictors of poor 90-day functional outcome (mRS >2) were identified after mechanical thrombectomy for acute ischemic stroke.
Pre-existing hypertension was independently associated with higher odds of unfavorable outcome.
Lower baseline ASPECTS was independently associated with unfavorable outcome.
Elevated neutrophil-to-lymphocyte ratio (NLR) was an independent predictor of unfavorable outcome.
Longer onset-to-reperfusion time (OTR) was independently associated with unfavorable outcome.
Delayed start of rehabilitation was an independent predictor of unfavorable outcome.
The multivariable model combining the predictors showed excellent discrimination for poor outcome.
Beyond successful recanalization (mTICI 2b-3), functional outcomes were independently influenced by factors across imaging, inflammation, and rehabilitation domains.
This study looked back at records of 144 people who had an ischemic stroke (caused by a blocked brain artery) and were treated with mechanical thrombectomy, a procedure that physically removes the clot. The researchers wanted to know which factors were linked to a poor recovery at 90 days, defined as significant disability on a standard scale (mRS above 2). Five factors were independently linked to worse outcomes: having high blood pressure before the stroke, a lower early brain scan score (ASPECTS, which reflects how much brain tissue was already damaged), a higher neutrophil-to-lymphocyte ratio (a blood marker of inflammation), a longer time from stroke onset to restored blood flow, and a later start of rehabilitation. A model combining these factors separated patients with good and poor outcomes very well (AUC 0.964). This research suggests that recovery after thrombectomy depends not only on whether the artery is reopened, but also on brain imaging, inflammation, and rehabilitation timing. However, the study was retrospective, small, and from a single analysis, and the very high accuracy figure and some wide confidence intervals (such as for hypertension) mean the results need confirmation in larger, independent studies before being relied on in practice.
Mu S, Li H, Wang Y, Liu Z, Wang Y, Liu B, et al.. (2026). Prognostic Evaluation of Acute Ischemic Stroke Patients After Mechanical Thrombectomy Incorporating Imaging, Inflammatory, and Rehabilitation Aspects.. Annali italiani di chirurgia. https://doi.org/10.62713/aic.4672