Predictors of discharge outcomes following percutaneous mechanical thrombectomy in patients with acute ischemic stroke: Comparisons between the home discharge group and hospital transfer group

Abstract

To clarify predictors of outcomes that can indicate the appropriateness of discharging patients to their own homes following acute ischemic stroke and percutaneous mechanical thrombectomy (PMT). This study included 99 patients with acute ischemic stroke who were hospitalized in the Department of Neurology at Hospital A and underwent PMT between April 2014 and December 2018. Of these, 32 and 67 patients were discharged to their own homes or to other hospitals, respectively. The following items were retrospectively collected from medical records within 3 days of PMT: age ; sex ; familial cohabitation and employment status ; serum albumin level ; consciousness disorders ; National Institutes of Health Stroke Scale (NIHSS), at the most severe time and at 24 hours postoperatively ; Brunnstrom recovery stage (BRS) in upper limbs, fingers, and lower limbs ; oral intake ; independence in activities of daily living such as eating, grooming, toileting, and walking ; and higher brain dysfunction. We identified significant differences between the groups in terms of consciousness disorders, both NIHSS scores, BRS, oral intake, independence in eating and grooming, and higher brain dysfunction (p<0.05). Multiple logistic regression analysis revealed the following significant predictors of outcomes : NIHSS score at 24 hours postoperatively (odds ratio [OR]: 1.35 ; 95% confidence interval [CI]: 0.1520.448) and oral intake (OR : 10.46, 95% CI : -2.252 to -0.095). NIHSS score at 24 hours postoperatively and oral intake are useful predictors of patient outcomes following PMT for acute ischemic stroke. These can be assessed even when bed rest levels are low.