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Ischemic stroke
Original research
Impact of smoking on one year functional outcomes after thrombectomy for young stroke patients
  1. Szu-Hsiang Peng1,
  2. Yen-Jun Lai1,
  3. Wei-Jen Lai1,
  4. Ai-Hsien Li2,
  5. Ho-Hsian Yen1,
  6. Lih-Wen Huang3,
  7. Chih-Wei Tang3,4
  1. 1Division of Medical Imaging, Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
  2. 2Department of Cardiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
  3. 3Department of Neurology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
  4. 4Institute of Brain Science, Brain Research Center, National Yang-Ming University, Taipei, Taiwan
  1. Correspondence to Dr Yen-Jun Lai, Division of Medical Imaging, Radiology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan; torogerlai{at}gmail.com

Abstract

Background The incidence of stroke in young patients (20–50 years old) has increased in recent decades. Unlike the use of good functional outcomes to evaluate prognosis, excellent functional outcomes are a better indicator of return to work among younger patients. The rate of return to work increases with time after stroke. This study investigated the short term (3 months) and long term (1 year) predictors of excellent functional outcomes in young patients after endovascular thrombectomy (EVT).

Methods We included young patients who underwent EVT for acute ischemic stroke (AIS) due to large vessel occlusion within 6 hours after stroke onset between 2015 and 2021. Patients with intracerebral hemorrhage on pretreatment CT were excluded. The associations between clinical, imaging, and procedure variables, and excellent functional outcomes were analyzed using univariate and multivariable logistic regression analyses. An excellent functional outcome was defined as a modified Rankin Scale score of ≤1.

Results Of the 361 patients with AIS eligible for EVT, 55 young patients (aged 24–50 years) were included. Of these, 36.4% and 41.8% achieved excellent functional outcomes at 3 and 12 months, respectively. Multivariate analysis revealed that smoking was the independent negative predictor of both 3 month (adjusted OR (aOR) 0.232, 95% CI 0.058 to 0.928; p=0.039) and 12 month (aOR 0.180, 95% CI 0.044 to 0.741; p=0.018) excellent functional outcomes.

Conclusions Current or former smoking habit was an independent negative predictor of both short term and long term excellent functional outcomes in young adults with AIS.

  • Stroke
  • Thrombectomy
  • Angiography
  • Atherosclerosis
  • CT Angiography

Data availability statement

No data are available.

https://doi.org/10.1136/jnis-2022-019815

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    Data availability statement

    No data are available.

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    Footnotes

    • S-HP and Y-JL contributed equally.

    • Contributors S-HP and Y-JL contributed equally to this paper. S-HP contributed to the collection of retrospective data, handling of privacy protection procedures, statistical analysis, and drafting of the manuscript. Y-JL contributed to the general conception, design, methodology, image analysis, drafting of the manuscript, and revision of the manuscript. W-JL, A-HL, and H-HY contributed to the image analysis in this study. L-WH and C-WT contributed to the clinical data analysis of this study. S-HP and Y-JL are guarantors of the overall content.

      Each author has reviewed the final manuscript and has agreed to the submission of this manuscript to the journal.

    • Funding This study was funded by Far Eastern Memorial Hospital (FEMH-2022-C-083).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.