Quality of life after stroke better with endovascular vs medical therapy

Stroke survivors treated with endovascular therapy have a more favourable quality of life (QoL)—including better mobility, increased social life, superior cognition, and less depression—than those who received medical therapy alone, according to a study.

The study used data from the DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) trial of 182 patients with acute anterior circulation ischaemic stroke who presented within 6 and 16 hours of the index event. They either received endovascular thrombectomy plus standard medical therapy or standard medical therapy alone.

There were 146 survivors at the 90-day follow-up. Of these, 136 (95 percent) completed Neurological Disorders short forms to assess QoL.

Results showed QoL scores were particularly higher in the group who had received endovascular therapy, especially in domains of mobility, social participation, cognitive function, and depression (p<0.01 for all).

Other factors significantly associated with better QoL included lower baseline National Institutes of Health Stroke Scale, younger age, and male sex.

Of note, the modified Rankin Scale (mRS) captured differences in QoL between patients, although the degree to which it did varied by domain. The mRS score accounted for a high proportion of the variability in mobility (Rs2=0.82), a moderate proportion in social participation (Rs2=0.62), and a low proportion in cognition (Rs2=0.31) and depression (Rs2=0.19).