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Outcomes and long‐term mortality after basilar artery occlusion—A cohort with up to 20 years' follow‐up.

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Title: Outcomes and long‐term mortality after basilar artery occlusion—A cohort with up to 20 years' follow‐up.
Authors: Ritvonen, Juhani (AUTHOR), Sairanen, Tiina (AUTHOR), Silvennoinen, Heli (AUTHOR), Virtanen, Pekka (AUTHOR), Salonen, Oili (AUTHOR), Lindsberg, Perttu J. (AUTHOR), Strbian, Daniel (AUTHOR)
Source: European Journal of Neurology. Mar2021, Vol. 28 Issue 3, p816-822. 7p.
Subjects: Arterial occlusions, Basilar artery, Mortality, Death rate, Causes of death
Abstract: Background: The data on long‐term outcome after basilar artery occlusion (BAO) are scarce. Little is known about BAO survivors´ outcome over decades. Aim: We set out to investigate long‐term survival and causes of death in BAO patients with up to two decades of follow‐up. We also evaluated differences in outcome trends. Methods: Two hundred and seven BAO patients treated with intravenous thrombolysis (IVT) at the Department of Neurology, Helsinki University Hospital, between 1995 and 2016, were analyzed. Short‐term outcome was assessed by modified Rankin Scale (mRS) at 3 months. Long‐term cumulative survival rate was analyzed using Kaplan−Meier analysis. Factors associated with mortality were analyzed with Cox regression. Results: Moderate outcome (mRS 0–3) was achieved in 41.1% and good outcome (mRS 0–2) in 30.4% of patients at 3 months. Three‐month mortality was 39.6%, of which 89% died within the first month. The median follow‐up time in 3‐month survivors was 8.9 years (maximum 21.8 years). Total mortality during follow‐up was 52.2%. Cumulative mortality rate was 25.7%. Older age, coronary artery disease and more extensive ischemic changes on admission brain imaging were independently associated with long‐term mortality. After the acute phase, the rate of other vascular causes of death increased in relation to stroke. Conclusions: The described evolution of a large, single‐center BAO cohort shows a trend towards a higher rate of good and/or moderate outcome during later years in IVT‐treated patients. Survivors showed relative longevity, and the rate of cardiac and other vascular causes of death increased in relation to stroke sequelae over the long term. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: Outcomes and long‐term mortality after basilar artery occlusion—A cohort with up to 20 years' follow‐up.
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  Data: <searchLink fieldCode="AR" term="%22Ritvonen%2C+Juhani%22">Ritvonen, Juhani</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sairanen%2C+Tiina%22">Sairanen, Tiina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Silvennoinen%2C+Heli%22">Silvennoinen, Heli</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Virtanen%2C+Pekka%22">Virtanen, Pekka</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Salonen%2C+Oili%22">Salonen, Oili</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lindsberg%2C+Perttu+J%2E%22">Lindsberg, Perttu J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Strbian%2C+Daniel%22">Strbian, Daniel</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Mar2021, Vol. 28 Issue 3, p816-822. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Arterial+occlusions%22">Arterial occlusions</searchLink><br /><searchLink fieldCode="DE" term="%22Basilar+artery%22">Basilar artery</searchLink><br /><searchLink fieldCode="DE" term="%22Mortality%22">Mortality</searchLink><br /><searchLink fieldCode="DE" term="%22Death+rate%22">Death rate</searchLink><br /><searchLink fieldCode="DE" term="%22Causes+of+death%22">Causes of death</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: The data on long‐term outcome after basilar artery occlusion (BAO) are scarce. Little is known about BAO survivors´ outcome over decades. Aim: We set out to investigate long‐term survival and causes of death in BAO patients with up to two decades of follow‐up. We also evaluated differences in outcome trends. Methods: Two hundred and seven BAO patients treated with intravenous thrombolysis (IVT) at the Department of Neurology, Helsinki University Hospital, between 1995 and 2016, were analyzed. Short‐term outcome was assessed by modified Rankin Scale (mRS) at 3 months. Long‐term cumulative survival rate was analyzed using Kaplan−Meier analysis. Factors associated with mortality were analyzed with Cox regression. Results: Moderate outcome (mRS 0–3) was achieved in 41.1% and good outcome (mRS 0–2) in 30.4% of patients at 3 months. Three‐month mortality was 39.6%, of which 89% died within the first month. The median follow‐up time in 3‐month survivors was 8.9 years (maximum 21.8 years). Total mortality during follow‐up was 52.2%. Cumulative mortality rate was 25.7%. Older age, coronary artery disease and more extensive ischemic changes on admission brain imaging were independently associated with long‐term mortality. After the acute phase, the rate of other vascular causes of death increased in relation to stroke. Conclusions: The described evolution of a large, single‐center BAO cohort shows a trend towards a higher rate of good and/or moderate outcome during later years in IVT‐treated patients. Survivors showed relative longevity, and the rate of cardiac and other vascular causes of death increased in relation to stroke sequelae over the long term. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/ene.14628
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        Text: English
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      – SubjectFull: Arterial occlusions
        Type: general
      – SubjectFull: Basilar artery
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      – SubjectFull: Mortality
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      – SubjectFull: Death rate
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              Text: Mar2021
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              Y: 2021
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