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Beharry, J., Yogendrakumar, V., Barros, G. W. F., Davis, S. M., Norrving, B., Figtree, G. A., . . . Eriksson, M. (2025). Mortality in ischaemic stroke patients without standard modifiable risk factors: An analysis of the Riksstroke registry. European Stroke Journal, Article ID 23969873241309516.
Öppna denna publikation i ny flik eller fönster >>Mortality in ischaemic stroke patients without standard modifiable risk factors: An analysis of the Riksstroke registry
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2025 (Engelska)Ingår i: European Stroke Journal, ISSN 2396-9873, E-ISSN 2396-9881, artikel-id 23969873241309516Artikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

INTRODUCTION: Little is known of the long-term prognosis of patients with acute ischaemic stroke in the absence of standard modifiable stroke risk factors (SMoRFs). In acute coronary syndromes, patients without modifiable risk factors have a higher mortality rate. We analysed data from the Swedish Stroke Register to determine survival of patients without SMoRFs following an ischaemic stroke.

PATIENTS AND METHODS: We identified adult patients with first-presentation acute ischaemic stroke between 2010 and 2020. Patients were considered to possess a SMoRF if they had one of: hypertension, diabetes, hyperlipidaemia, atrial fibrillation or an active smoking history. We compared mortality in patients with and without SMoRFs following first-presentation ischaemic stroke using cox regression models. We also assessed the combined endpoint death and dependency (mRS 3-6) at 3 months via logistic regression models.

RESULTS: Of 152,588 patients with ischaemic stroke, hypertension (58.7%) and atrial fibrillation (27.3%) were the most common risk factors. 34,019 patients (22.3%) had no SMoRFs. After a first-presentation ischaemic stroke, patients without SMoRFs had a lower risk of death than patients with one or more SMoRFs (HR 0.58 [95% CI 0.57-0.59]). The absence of SMoRFs was associated with lower odds of death and dependency at 3 months in logistic regression models (OR 0·60 [95% CI 0.58-0.62]).

CONCLUSION: One in five patients with acute ischaemic stroke had no standard modifiable stroke risk factors. These patients have lower risk of death compared to patients with one or more SMoRFs.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2025
Nyckelord
Stroke, death, dependency, mortality, risk factors
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:oru:diva-118178 (URN)10.1177/23969873241309516 (DOI)001387798900001 ()39745075 (PubMedID)2-s2.0-85213965259 (Scopus ID)
Tillgänglig från: 2025-01-10 Skapad: 2025-01-10 Senast uppdaterad: 2025-01-20Bibliografiskt granskad
Tallroth, M., Udumyan, R., Büki, A. & von Euler, M. (2024). Antithrombotic Treatment and Clinical Outcomes After Intracerebral Hemorrhage: A Retrospective Cohort Study from the Swedish Stroke Register. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 13(10), Article ID e034716.
Öppna denna publikation i ny flik eller fönster >>Antithrombotic Treatment and Clinical Outcomes After Intracerebral Hemorrhage: A Retrospective Cohort Study from the Swedish Stroke Register
2024 (Engelska)Ingår i: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, E-ISSN 2047-9980, Vol. 13, nr 10, artikel-id e034716Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: A rapid shift has occurred from vitamin K antagonists toward direct oral anticoagulants, which have a lower risk of intracerebral hemorrhage (ICH). However, effects on clinical outcomes after ICH are understudied. We aimed to describe the prevalence of antithrombotic drugs and to study the prognosis among prestroke functionally independent Swedish patients with ICH.

METHODS AND RESULTS: We identified all patients diagnosed with nontraumatic ICH in 2017 to 2021 from the Swedish Stroke Register (n=13 155) and assessed death and functional outcome at 3 months after ICH in prestroke functionally independent patients (n=10 014). Functional outcome was estimated among 3-month survivors on the basis of self-reported activities of daily living scores. Risks of outcomes were estimated using Poisson regression. In 13 155 patients, 14.5% used direct oral anticoagulant, 10.1% vitamin K antagonists, and 21.6% antiplatelets at ICH onset. Among 10 014 pre-stroke activities of daily living-independent patients, oral anticoagulants and antiplatelets were associated with increased mortality risk (adjusted risk ratio, 1.27 [95% CI, 1.13-1.43]; P<0.001; and adjusted risk ratio, 1.23 [95% CI, 1.13-1.34]; P<0.001 respectively). Mortality risk did not statistically differ between antiplatelets and oral anticoagulants nor between direct oral anticoagulant and vitamin K antagonists. Among 5126 patients with nonmissing functional outcome (69.1% of survivors), antiplatelets (adjusted risk ratio, 1.06 [95% CI, 0.99-1.13]; P=0.100) and oral anticoagulants (adjusted risk ratio, 1.01 [95% CI, 0.92-1.12]; P=0.768) were not statistically significantly associated with functional dependence.

CONCLUSIONS: There was no statistically significant difference in mortality risk between direct oral anticoagulant and vitamin K antagonists in prestroke functionally independent patients (unadjusted for oral anticoagulant class indication). Furthermore, mortality risk in antiplatelet and oral anticoagulant users might differ less than previously suggested.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2024
Nyckelord
Antithrombotic drugs, death, functional outcome, intracerebral hemorrhage, oral anticoagulants
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:oru:diva-113689 (URN)10.1161/JAHA.123.034716 (DOI)001228221200017 ()38726922 (PubMedID)2-s2.0-85194013585 (Scopus ID)
Forskningsfinansiär
STROKE-Riksförbundet
Anmärkning

The study was funded by the Swedish Stroke Foundation and by grants provided by the “Avtal om Läkarutbildning och Forskning agreement,” an agreement between the Swedish government and the Region Örebro Council. 

Tillgänglig från: 2024-05-23 Skapad: 2024-05-23 Senast uppdaterad: 2024-07-04Bibliografiskt granskad
Lindström, V., Romanitan, M. O., Berglund, A., Pirvulescu, R. A., von Euler, M. & Bohm, K. (2024). Callers' Descriptions of Stroke Symptoms during Emergency Calls in Victims Who Have Fallen or Been Found Lying Down: A Qualitative Content Analysis. Healthcare, 12(4), Article ID 497.
Öppna denna publikation i ny flik eller fönster >>Callers' Descriptions of Stroke Symptoms during Emergency Calls in Victims Who Have Fallen or Been Found Lying Down: A Qualitative Content Analysis
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2024 (Engelska)Ingår i: Healthcare, E-ISSN 2227-9032, Vol. 12, nr 4, artikel-id 497Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Early identification of stroke symptoms is essential. The rate of stroke identification by call-takers at emergency medical communication centres (EMCCs) varies, and patients who are found in a lying down position are often not identified as having an ongoing stroke.

OBJECTIVES: this study aimed to explore signs and symptoms of stroke in patients who had fallen or were found in a lying position.

DESIGN: a retrospective exploratory qualitative study design was used.

METHOD: a total of 29 emergency calls to EMCCs regarding patients discharged with a stroke diagnosis from a large teaching hospital in Stockholm, Sweden, in January-June 2011, were analysed using qualitative content analysis.

RESULTS: during the emergency calls, the callers described a sudden change in the patient's health status including signs such as the patient's loss of bodily control, the patient's perception of a change in sensory perception, and the callers' inability to communicate with the patient.

CONCLUSIONS: The callers' descriptions of stroke in a person found in a lying position are not always as described in assessment protocols describing the onset of a stroke. Instead, the symptom descriptions are much vaguer. Therefore, to increase identification of stroke during emergency calls, there is a need for an increased understanding of how callers describe stroke symptoms and communicate with the call-takers.

Ort, förlag, år, upplaga, sidor
MDPI, 2024
Nyckelord
Content analysis, dispatch centre, emergency call, stroke
Nationell ämneskategori
Omvårdnad
Identifikatorer
urn:nbn:se:oru:diva-111957 (URN)10.3390/healthcare12040497 (DOI)001170059600001 ()38391872 (PubMedID)2-s2.0-85185691928 (Scopus ID)
Forskningsfinansiär
STROKE-RiksförbundetKarolinska InstitutetStockholms läns landsting
Anmärkning

The third author had financial support from The Swedish Stroke Association (Stroke-Riksförbundet) and Södersjukhuset, the Department of Internal Medicine. This study is a part of the Fighting Stroke Project (Uppdrag Besegra Stroke), supported by the Swedish Heart and Lung Foundation and Karolinska Institutet; the project is supported by funding from Friends of Karolinska Institutet, USA, and Johanniterorden. Financial support was provided through the Centre for Gender Medicine at Karolinska Institutet and from the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet.

Tillgänglig från: 2024-02-26 Skapad: 2024-02-26 Senast uppdaterad: 2025-01-03Bibliografiskt granskad
Gunnarsson, K., Tofiq, a., Mathew, A., Cao, Y., von Euler, M. & Ström, J. O. (2024). Changes in stroke and TIA admissions during the COVID-19 pandemic: A meta-analysis. European Stroke Journal, 9(1), 78-87
Öppna denna publikation i ny flik eller fönster >>Changes in stroke and TIA admissions during the COVID-19 pandemic: A meta-analysis
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2024 (Engelska)Ingår i: European Stroke Journal, ISSN 2396-9873, E-ISSN 2396-9881, Vol. 9, nr 1, s. 78-87Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

PURPOSE: To perform a meta-analysis on how the admissions of stroke and transient ischemic attack (TIA) changed during the Corona Virus infection-19 (COVID-19) pandemic and evaluate if the effect was depending on stroke severity.

METHODS: Observational cohort studies comparing the number of stroke and/or TIA admissions during a period of the pandemic compared to a period before the pandemic were identified in PubMed and Embase. After excluding studies with overlapping populations and studies without satisfactory case ascertainment, data was extracted and meta-analyzed.

FINDINGS: A total of 59 studies were included. During the pandemic, there was a decrease in admissions of ischemic stroke (admission rate ratio (ARR) = 0.77, 95% confidence interval (CI): 0.72, 0.82), intracerebral hemorrhage (ARR = 0.79, 95% CI: 0.70, 0.90) and TIA (ARR = 0.66, 95% CI: 0.58, 0.75). Albeit admission rates of both mild (ARR = 0.61, 95% CI: 0.49, 0.77) and severe (ARR = 0.82, 95% CI = 0.71, 0.95) strokes decreased, milder strokes decreased more (proportion ratio (PR) = 0.76, 95% CI: 0.65, 0.89).

DISCUSSION: Potential causes for the admission reduction could be strict prioritizations within the health care, patients' fear of acquiring COVID-19, or decreased access to health care due to lockdowns.

CONCLUSION: During the COVID-19 pandemic, there was a reduction in admissions of stroke and TIA, possibly caused by reluctance to seek medical care.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2024
Nyckelord
Acute ischemic stroke, Corona virus, NIHSS, SARS-CoV-2, TIA, cerebral infarction, intracerebral hemorrhage
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Neurologi
Identifikatorer
urn:nbn:se:oru:diva-108656 (URN)10.1177/23969873231204127 (DOI)001073208700001 ()37776062 (PubMedID)2-s2.0-85173493290 (Scopus ID)
Tillgänglig från: 2023-10-02 Skapad: 2023-10-02 Senast uppdaterad: 2024-03-22Bibliografiskt granskad
Petrović, A. T. & von Euler, M. (2024). Comparative drug utilization research comparing different patients. In: Drug Utilization Research: Methods and Applications (pp. 292-302). Wiley
Öppna denna publikation i ny flik eller fönster >>Comparative drug utilization research comparing different patients
2024 (Engelska)Ingår i: Drug Utilization Research: Methods and Applications, Wiley , 2024, s. 292-302Kapitel i bok, del av antologi (Övrigt vetenskapligt)
Abstract [en]

Comparative drug utilization research based on patient characteristics provides a significant contribution to the knowledge on use of drugs in the real world. Through observing differences in medication use based on different patient characteristics it is possible to identify possible underuse, overuse, or inappropriate use of drugs in specific patient populations. This chapter focuses on patient characteristics in the context of drug utilization research (DUR) and describes the possible reasons for differences in medicine use in different patients, including associated challenges and opportunities. Differences in health-seeking behaviours also contribute to the differences in drug use in different patients. Women seek health care more frequently and participate in preventive health care measures more readily than men. Age is a characteristic influencing drug utilization that is commonly included in DUR. In addition to age and sex, sociodemographic factors such as ethnicity, education, occupation, and socio-economic status are often reported in drug utilization studies as explanatory variables.

Ort, förlag, år, upplaga, sidor
Wiley, 2024
Nyckelord
Drug utilization, Education, Ethnicity, Health care, Medication, Occupation, Patient characteristics
Nationell ämneskategori
Farmakologi och toxikologi
Identifikatorer
urn:nbn:se:oru:diva-118422 (URN)10.1002/9781119911685.ch27 (DOI)2-s2.0-85211860099 (Scopus ID)9781118949764 (ISBN)
Anmärkning

Second edition

Tillgänglig från: 2025-01-14 Skapad: 2025-01-14 Senast uppdaterad: 2025-01-14Bibliografiskt granskad
Abzhandadze, T., Hoang, M. T., Mo, M., Mostafaei, S., Jurado, P. G., Xu, H., . . . Garcia-Ptacek, S. (2024). COVID-19 Pandemic and Stroke Care in Patients With Dementia Compared to Other Stroke Patients. Journal of the American Medical Directors Association, 25(7), Article ID 105011.
Öppna denna publikation i ny flik eller fönster >>COVID-19 Pandemic and Stroke Care in Patients With Dementia Compared to Other Stroke Patients
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2024 (Engelska)Ingår i: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 25, nr 7, artikel-id 105011Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVES: The primary objective of this study was to examine the impact of the COVID-19 pandemic on the quality of stroke care for patients with preexisting dementia, compared with patients who had only stroke. The secondary aim was to investigate how the quality of stroke care changed during the pandemic and post-pandemic periods compared with the pre-pandemic period in patients with preexisting dementia.

DESIGN: A registry-based, nationwide cohort study in Sweden.

SETTING AND PARTICIPANTS: We included patients with a first stroke between 2019 and 2022, both with and without dementia. The study periods were defined as follows: pre-pandemic (January 1, 2019, to February 29, 2020), COVID-19 pandemic (March 1, 2020, to February 24, 2022), and post-COVID-19 pandemic period (February 25, 2022, to September 19, 2022). The outcomes examined were the following quality indicators of stroke care, suggested by the national guideline of stroke care in Sweden: stroke admission site, performance of swallowing assessment, reperfusion treatment, assessment for rehabilitation, and early supported discharge.

METHODS: The associations were studied through group comparisons and binary logistic regressions.

RESULTS: Of the 21,795 stroke patients, 1357 had documented preexisting dementia, and 20,438 had stroke without a dementia diagnosis. Throughout all study periods, a significantly lower proportion of stroke patients with preexisting dementia, compared with stroke-only patients, received reperfusion treatment, assessments for rehabilitation, and early supported discharge from stroke units. In the subgroup of stroke patients with preexisting dementia, no significant associations were found regarding the quality indicators of stroke care before, during, and after the pandemic.

CONCLUSIONS AND IMPLICATIONS: Disparities in quality of stroke care were observed between stroke patients with preexisting dementia and those with only stroke during the COVID-19 pandemic. However, there were no statistically significant differences in stroke care for patients with dementia across the pandemic.

Ort, förlag, år, upplaga, sidor
Lippincott Williams & Wilkins, 2024
Nyckelord
Dementia, Epidemiology, Health care, Impact, Outcomes, Pandemic, SARS-CoV-2, Stroke, Stroke unit
Nationell ämneskategori
Neurologi Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:oru:diva-113567 (URN)10.1016/j.jamda.2024.03.122 (DOI)001242238900001 ()38702044 (PubMedID)2-s2.0-85192976242 (Scopus ID)
Forskningsfinansiär
Karolinska InstitutetSTROKE-RiksförbundetKarolinska Institutets ForskningsstiftelseVetenskapsrådet
Anmärkning

Open access funding is provided by Karolinska Institutet. This work was supported by the Loo and Hans Osterman Foundation (#2023-01697), the Swedish Stroke Association (Strokeförbundets Stiftelser och Fonder), Karolinska Institutet's Research Foundation Grants, Emil and Wera Cornell's Foundation, and the Swedish Research Council.

Tillgänglig från: 2024-05-08 Skapad: 2024-05-08 Senast uppdaterad: 2024-07-22Bibliografiskt granskad
Sanner, J., Ström, J. O., von Euler, M., Thommessen, B. & Fure, B. (2024). Etiological Subclassification of Stroke in Older People ≥80 Years Compared to Younger People: A Systematic Review and Meta-Analysis. Journal of Geriatric Psychiatry and Neurology, 37(6), 436-447
Öppna denna publikation i ny flik eller fönster >>Etiological Subclassification of Stroke in Older People ≥80 Years Compared to Younger People: A Systematic Review and Meta-Analysis
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2024 (Engelska)Ingår i: Journal of Geriatric Psychiatry and Neurology, ISSN 0891-9887, E-ISSN 1552-5708, Vol. 37, nr 6, s. 436-447Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

BACKGROUND: Due to the rapid growth of the world´s oldest population, the number of older persons with stroke is expected to rise. Knowledge of stroke etiology is essential to offer personalized and equal health care across age groups. The present systematic review aimed to investigate the prevalence of etiological subtypes of ischemic and hemorrhagic stroke in older compared to younger people.

METHODS: MEDLINE, Embase, Cochrane, Epistemonikos, and Cinahl were systematically searched for studies regarding etiological classification in people ≥80 years compared to those <80 years with ischemic or hemorrhagic stroke.

RESULTS: Out of 28 441 identified articles, eight met the inclusion criteria. In total, 8223 individuals were included in meta-analyses, of whom 2997 were 80 years or older. We demonstrated a higher prevalence of cardioembolic stroke in people ≥80 years OR 1.68 (95% CI, 1.12-2.53). Small vessel disease was significantly less common in older people OR .64 (95% CI, .50-.81). Regarding large vessel disease, no statistically significant difference between the two groups was shown OR 1.05 (95% CI, .77-1.43).

CONCLUSION: In people ≥80 years, cardioembolic stroke is more common, and small vessel disease less common compared to people <80 years. Overall, the results have to be interpreted with caution due to few studies. Large studies using validated classification systems are needed.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2024
Nyckelord
Etiological classification, hemorrhagic stroke, ischemic stroke, meta-analysis, people ≥ 80 years, systematic review
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:oru:diva-113754 (URN)10.1177/08919887241254466 (DOI)001226517100001 ()38761091 (PubMedID)2-s2.0-85193500714 (Scopus ID)
Forskningsfinansiär
Örebro universitetRegion Värmland
Tillgänglig från: 2024-05-22 Skapad: 2024-05-22 Senast uppdaterad: 2024-10-01Bibliografiskt granskad
Tofiq, a., Eriksson Crommert, M., Zakrisson, A.-B., von Euler, M. & Nilsing Strid, E. (2024). Physical functioning post-COVID-19 and the recovery process: a mixed methods study. Disability and Rehabilitation, 46(8), 1570-1579
Öppna denna publikation i ny flik eller fönster >>Physical functioning post-COVID-19 and the recovery process: a mixed methods study
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2024 (Engelska)Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 46, nr 8, s. 1570-1579Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

PURPOSE: To describe physical functioning after severe COVID-19-infection.

MATERIALS AND METHOD: An explanatory sequential mixed method design was used. Thirty-nine participants performed tests and answered questionnaires measuring physical functioning six months after hospitalisation due to COVID-19. Thirty of these participants participated in semi-structured interviews with questions regarding how they perceived their physical functioning and recovery from COVID-19 at 12 months post-hospitalisation.

RESULTS: At six months, physical functioning measured via chair stand test and hip-worn accelerometers was lower than normal reference values. There was a reduction in breathing muscle strength. Participants estimated their functional status during different activities as lower compared to those before COVID-19-infection, measured with a patient-specific functional scale. At one year after infection, there were descriptions of a rough recovery process and remaining symptoms.

CONCLUSION: Patients recovering from severe COVID-19 seem to have reduced physical functioning and activity levels, and they perceive their recovery to be slow and difficult. They experienced a lack of clinical support and contradictory advice regarding rehabilitation. Coaching in returning to physical functioning after the infection needs to be better co-ordinated and there is a need for guidelines for health professionals to avoid patients receiving contradictory advice.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2024
Nyckelord
COVID-19, SARS-CoV-2, exercise, physical activity, qualitative research, recovery of function, rehabilitation, severe acute respiratory syndrome
Nationell ämneskategori
Idrottsvetenskap och fitness
Identifikatorer
urn:nbn:se:oru:diva-105614 (URN)10.1080/09638288.2023.2201512 (DOI)000971399700001 ()37078388 (PubMedID)2-s2.0-85153473582 (Scopus ID)
Tillgänglig från: 2023-04-21 Skapad: 2023-04-21 Senast uppdaterad: 2025-02-11Bibliografiskt granskad
Lindmark, A., von Euler, M., Glader, E.-L., Sunnerhagen, K. S. & Eriksson, M. (2024). Socioeconomic Differences in Patient Reported Outcome Measures 3 Months After Stroke: A Nationwide Swedish Register-Based Study. Stroke, 55(8), 2055-2065
Öppna denna publikation i ny flik eller fönster >>Socioeconomic Differences in Patient Reported Outcome Measures 3 Months After Stroke: A Nationwide Swedish Register-Based Study
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2024 (Engelska)Ingår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 55, nr 8, s. 2055-2065Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: There is a well-known association between low socioeconomic status (SES), poor survival, and clinician-reported outcomes after stroke. We aimed to assess socioeconomic differences in Patient Reported Outcome Measures 3 months after stroke.

METHODS: This nationwide cohort study included patients registered with acute stroke in the Swedish Stroke Register 2015-2017. Patient Reported Outcome Measures included activities of daily living (mobility, toileting, and dressing), and poststroke symptoms (low mood, fatigue, pain, and poor general health). Information on SES prestroke was retrieved from Statistics Sweden and defined by a composite measure based on education and income tertiles. Associations between SES and Patient Reported Outcome Measures were analyzed using logistic regression adjusting for confounders (sex and age) and additionally for potential mediators (stroke type, severity, cardiovascular disease risk factors, and living alone). Subgroup analyses were performed for stroke type, men and women, and younger and older patients.

RESULTS: The study included 44 511 patients. Of these, 31.1% required assistance with mobility, 18% with toileting, and 22.2% with dressing 3 months after stroke. For poststroke symptoms, 12.3% reported low mood, 39.1% fatigue, and 22.7% pain often/constantly, while 21.4% rated their general health as poor/very poor. Adjusted for confounders, the odds of needing assistance with activities of daily living were highest for patients with low income and primary school education, for example, for mobility, odds ratio was 2.06 (95% CI, 1.89-2.24) compared with patients with high income and university education. For poststroke symptoms, odds of poor outcome were highest for patients with low income and university education (eg, odds ratio, 1.79 [95% CI, 1.49-2.15] for low mood). Adjustments for potential mediators attenuated but did not remove associations. The associations were similar in ischemic and hemorrhagic strokes and more pronounced in men and patients <65 years old.

CONCLUSIONS: There are substantial SES-related differences in Patient Reported Outcome Measures poststroke. The more severe outcome associated with low SES is more pronounced in men and in patients of working age.

Ort, förlag, år, upplaga, sidor
Lippincott Williams & Wilkins, 2024
Nyckelord
Patient Reported Outcome Measures, activities of daily living, health status, low socioeconomic status, stroke
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:oru:diva-114543 (URN)10.1161/STROKEAHA.124.047172 (DOI)001272487000011 ()38946533 (PubMedID)2-s2.0-85199283597 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2018-00852Vetenskapsrådet, 2018-02670
Tillgänglig från: 2024-07-01 Skapad: 2024-07-01 Senast uppdaterad: 2024-08-19Bibliografiskt granskad
Ullberg, T., von Euler, M., Wester, P., Arnberg, F., Norrving, B., Andersson, T. & Wassélius, J. (2023). Endovascular thrombectomy for anterior circulation stroke beyond 6 hours of onset in Sweden 2015 to 2020: rates and outcomes in a nationwide register-based study. Journal of neurointerventional surgery, 15(4), 330-335
Öppna denna publikation i ny flik eller fönster >>Endovascular thrombectomy for anterior circulation stroke beyond 6 hours of onset in Sweden 2015 to 2020: rates and outcomes in a nationwide register-based study
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2023 (Engelska)Ingår i: Journal of neurointerventional surgery, E-ISSN 1759-8486, Vol. 15, nr 4, s. 330-335Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Endovascular thrombectomy (EVT) for ischemic stroke (IS) beyond 6 hours has been proven effective in randomized controlled trials. We present data on implementation and outcomes for EVT beyond 6 hours in Sweden.

METHODS: We included all cases of anterior circulation IS caused by occlusion of the intracranial carotid artery, and the M1 or M2 segment of the middle cerebral artery, registered in two nationwide quality registers for stroke in 2015-2020. Three groups were defined from onset-to-groin-puncture (OTG) time: early window (<6 hours), late window (6-24 hours) known onset, late window last seen well (LSW). Favorable outcome (modified Rankin Scale (mRS) 0-2) and all-cause mortality at 90 days were the main outcomes, and symptomatic intracerebral hemorrhage (sICH) was the safety outcome.

RESULTS: Late window EVT increased from 0.3% of all IS in 2015 to 1.8% in 2020, and from 17.4% of all anterior circulation EVTs in 2015 to 32.9% in 2020. Of 2199 patients, 76.9% (n=1690) were early window EVTs and 23.1% late window EVTs (n=509; 141 known onset, 368 LSW). Median age was 73 years, and 46.2% were female, with no differences between groups. Favorable outcome did not differ between groups (early window 42.4%, late window known onset 38.9%, late window LSW 37.3% (p=0.737)) and remained similar when adjusted for baseline differences. sICH rates did not differ (early window 4.0%, late window known onset 2.1%, late window LSW 4.9% (p=0.413)).

CONCLUSION: Late window EVTs have increased substantially over time, and currently account for one third of anterior circulation treatments. Early and late window patients had similar outcomes.

Ort, förlag, år, upplaga, sidor
BMJ Publishing Group Ltd, 2023
Nyckelord
CT perfusion, Stroke, Thrombectomy, Thrombolysis
Nationell ämneskategori
Neurologi
Identifikatorer
urn:nbn:se:oru:diva-98156 (URN)10.1136/neurintsurg-2022-018670 (DOI)000771049800001 ()35301261 (PubMedID)2-s2.0-85150311660 (Scopus ID)
Forskningsfinansiär
Crafoordska stiftelsen
Anmärkning

Funding agencies:

Regional ALF grants

SUS Stiftelser och Fonder

Tillgänglig från: 2022-03-21 Skapad: 2022-03-21 Senast uppdaterad: 2024-01-02Bibliografiskt granskad
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