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Stroke by basilar artery occlusion: outcome of 71 patients hospitalized in a neurological intensive care unit
Mémoire de Master / Thèse d'exercice   Open Access

Stroke by basilar artery occlusion: outcome of 71 patients hospitalized in a neurological intensive care unit

Christopher Scott
Masters , Université de Montpellier
03/10/2019

Résumé

Mechanical thrombectomy Tronc basilaire Basilar artery Stroke Intensive care units Prognosis Accident vasculaire cérébral Thrombectomie Réanimation Pronostic
Introduction: acute basilar artery occlusion (ABAO) is a devastating type of stroke, with a high mortality rate and functional dependence and a frequent need for intensive care. We studied the outcome of patients suffering from ABAO hospitalized in a neuro-intensive care unit (ICU) after an endovascular procedure, and we searched for prognostic factors.Method: we conducted, from 2011 to 2017, a retrospective, monocentric study in a French neuro-ICU. We determined the outcome at 90 days using the modified Rankin Scale (mRS) score and compared patients with a good outcome (mRS 0-2) to patients with a bad outcome (mRS 3-6).Results: seventy-one patients were included. The median age was 66 years old. The median NIHSS score was 14. The median PC-ASPECTS was 8. The median delay between the last neurological worsening and recanalization was 466 (366-603) minutes. Sixty-nine percent had a good TICI score (2b-3) after MT. The median SAPS II was 45 and was significantly lower in patients with a good outcome, (34 vs. 48, p<0.01, adjusted odds ratio=1.090). The mortality rate was 55%. In total, 21% of patients had a good outcome and 79% a bad outcome at 90 days.Discussion: patients who suffer from ABAO, treated by an endovascular treatment and who necessitate care in an intensive ward have a high mortality rate and a bad functional outcome at 90 days. The only prognostic factor in our population was the SAPS II score. Other usual prognostic factors do not seem to be applicable on such a population.

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