Predictors of mortality for acute vertebrobasilar artery occlusion receiving endovascular treatment.

Abstract

Acute vertebrobasilar artery occlusion (VBAO) is a devastating type of stroke with a high mortality rate. This study aimed to investigate the predictors of 3-month and 1-year mortality in VBAO patients receiving endovascular treatment (EVT). Consecutive acute VBAO patients undergoing EVT between January 2014 and December 2019 were retrospectively analyzed in a prospectively maintained database. Multivariate logistical regression models were used to explore the potential predictors of mortality at 3months and 1year, respectively. The discrimination of the final model was assessed with the area under the receiver operating characteristic curve. A total of 100 patients were enrolled in this study (mean age 62years; 77.0% male). After excluding patients lost to follow-up, the overall mortality rate was 34.3% (34/99) at 3months and 45.4% (44/97) at 1year. The Glasgow Coma Scale (GCS) score at 24h (Odds ratio [OR], 0.676; 95% confidence interval [CI], 0.540-0.846; p=.001) and mechanical ventilation (MV) (OR, 7.356; 95% CI, 2.200-24.593; p=.001) were predictors of 3-month mortality after adjusting for potential confounders in multivariable analysis. Furthermore, the GCS score at 24h (OR, 0.714; 95% CI, 0.590-0.864; p=.001), intracranial hemorrhage (OR, 7.330; 95% CI, 1.772-30.318; p=.006), and MV (OR, 5.804; 95% CI, 1.841-18.294; p=.003) were independently associated with mortality at 1year. Sensitivity analyses showed similar results. The 24-h GCS score and MV were common predictors of 3-month and 1-year mortality, and ICH was an additional predictor of 1-year mortality.