Titre
CT-angiography source images indicate less fatal outcome despite coma of patients in the Basilar Artery International Cooperation Study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Pallesen, L.P.
Auteure/Auteur
Khomenko, A.
Auteure/Auteur
Dzialowski, I.
Auteure/Auteur
Barlinn, J.
Auteure/Auteur
Barlinn, K.
Auteure/Auteur
Zerna, C.
Auteure/Auteur
van der Hoeven, E.J.
Auteure/Auteur
Algra, A.
Auteure/Auteur
Kapelle, L.J.
Auteure/Auteur
Michel, P.
Auteure/Auteur
Bodechtel, U.
Auteure/Auteur
Demchuk, A.M.
Auteure/Auteur
Schonewille, W.
Auteure/Auteur
Puetz, V.
Auteure/Auteur
Groupes de travail
BASICS-Study group
Liens vers les personnes
Liens vers les unités
ISSN
1747-4949
Statut éditorial
Publié
Date de publication
2017-04
Volume
12
Numéro
2
Première page
145
Dernière page/numéro d’article
151
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Background Coma is associated with poor outcome in patients with basilar artery occlusion. Aims We sought to assess whether the posterior circulation Acute Stroke Prognosis Early CT Score and the Pons-Midbrain Index applied to CT angiography source images predict the outcome of comatose patients in the Basilar Artery International Cooperation Study. Methods Basilar Artery International Cooperation Study was a prospective, observational registry of patients with acute basilar artery occlusion with 48 recruiting centers worldwide. We applied posterior circulation Acute Stroke Prognosis Early CT Score and Pons-Midbrain Index to CT angiography source images of Basilar Artery International Cooperation Study patients who presented with coma. We calculated adjusted risk ratios to assess the association of dichotomized posterior circulation Acute Stroke Prognosis Early CT Score (≥8 vs. <8) and Pons-Midbrain Index (<3 vs. ≥3) with mortality and favourable outcome (modified Rankin Scale score 0-3) at one month. Results Of 619 patients in the Basilar Artery International Cooperation Study registry, CT angiography source images were available for review in 158 patients. Among these, 78 patients (49%) presented with coma. Compared to non-comatose patients, comatose patients were more likely to die (risk ratios 2.34; CI 95% 1.56-3.52) and less likely to have a favourable outcome (risk ratios 0.44; CI 95% 0.24-0.80). Among comatose patients, a Pons-Midbrain Index < 3 was related to reduced mortality (adjusted RR 0.66; 95% CI 0.46-0.96), but not to favourable outcome (adjusted RR 1.19; 95% CI 0.39-3.62). Posterior circulation Acute Stroke Prognosis Early CT Score dichotomized at ≥ 8 vs. <8 was not significantly associated with death (adjusted RR 0.70; 95% CI 0.46-1.05). Conclusion In comatose patients with basilar artery occlusion, the extent of brainstem ischemia appears to be related to mortality but not to favourable outcome.
PID Serval
serval:BIB_B36B6C322680
PMID
Date de création
2016-10-11T15:38:07.087Z
Date de création dans IRIS
2025-05-21T03:21:13Z