Reader Response: Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke

We read with interest the article by de Havenon et al.1 In this study, the authors performed a post hoc analysis in patients with thrombectomy to examine the relationship between premorbid disability and outcome of endovascular therapy by using the modified Rankin Scale (mRS). They found that patients without premorbid disability were more likely to accumulate further disability than those patients with premorbid disability, but patients with premorbid disability had a higher mortality. The modified Rankin Scale is used to evaluate the neurologic recovery of patients with stroke2 and is also widely used in clinical practice including cerebral infarction,2 cerebral hemorrhage,3 and cardiac arrest.4 However, the reasons for patients’ prestroke disability and death after 90-day follow-up were unclear. Epidemiologic studies show that primary causes of disability vary across different age populations. Ischemic heart diseases and stroke are the primary causes of disability in 50–74-year-olds and those who are aged 75 years and over, respectively.5 In this study, it was unclear whether ischemic heart diseases or other noncerebrovascular causes were the main cause of prestroke disability and death. Additional investigations are needed to identify the indications and contraindications for endovascular therapy in patients with anterior circulation occlusion, which will benefit treatment of patients with stroke.

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