Background:
Endovascular thrombectomy (EVT) improves 90-day disability in patients following acute ischemic stroke due to large vessel occlusion. However, the effect of EVT on health-related quality of life and specific functional domains, and whether this effect differs by age or sex is less studied.
Methods:
We used data from the ESCAPE randomized controlled trial to obtain EuroQol-5D-3L (EQ-5D) at 90 days after acute stroke in patients randomized to EVT or standard care. Death was assigned an index value of 0 for EQ-5D. We used quantile regression to evaluate the association between EVT and EQ-5D index scores, and logistic regression for the association between EVT and symptom-free status among 90-day survivors for each EQ-5D dimension (self-care, usual activities, mobility, pain/discomfort, and anxiety/depression), assessing for modification by age or sex and adjusting for baseline factors including stroke severity, affected hemisphere, and receipt of alteplase.
Results:
There were 165 patients randomized to EVT and 150 patients randomized to control. Median EQ-5D was significantly higher for those who received EVT (0.80 versus 0.60; p<0.001). There was evidence of modification by age with older age associated with greater improvements in EQ-5D with EVT (Figure). Those receiving EVT had higher odds of symptom-free status in self-care, usual activities, mobility for those aged 60-79, and pain/discomfort for women, with no association with anxiety/depression (Table).
Conclusions:
EVT substantially improves health-related quality of life, with relatively greater impact in older individuals and observed benefit across multiple dimensions.
MP39-14 IS STONE-FREE STATUS AFTER SURGICAL INTERVENTION FOR KIDNEY STONES ASSOCIATED WITH BETTER HEALTH-RELATED QUALITY OF LIFE? A MULTICENTER STUDY FROM THE NORTH AMERICAN STONE QUALITY OF LIFE CONSORTIUM
