Table 3. Association of Presence or Absence of CT Perfusion Mismatch Profile With Clinical Outcomes Within Patients Receiving Endovascular Thrombectomy and Medical Management (As-Treated Analysis)a.
| Outcome | Endovascular thrombectomy (n = 170) | Medical care only (n = 166) | P value for interaction |
|---|---|---|---|
| Presence of mismatch profile (mismatch volume ≥10 mL and mismatch ratio ≥1.2)—based on CTP/MRI core volume | |||
| mRS distributionb | |||
| No mismatch, median (IQR) [reference] | 4 (3.5-6) [n = 8] | 5 (4-6) [n=21] | |
| Mismatch, median (IQR) | 4 (3-6) [n = 162] | 5 (4-6) [n = 145] | |
| Effect size with uncertainty estimates | aGenOR, 0.84 (95% CI, 0.39 to 1.82) | aGenOR, 0.78 (95% CI, 0.48 to 1.27) | .88 |
| Functional independence (mRS 0-2b) | |||
| No mismatch, No./total (%) [reference] | 0/8 | 1/21 (4.8) | |
| Mismatch, No./total (%) | 34/162 (21.0) | 11/145 (7.6) | |
| Effect size with uncertainty estimates | aRR, 1.01 (95% CI, 0.21 to 4.92) aRD, –0.001 (95% CI, −0.138 to 0.136) |
||
| Independent ambulation (mRS 0-3b) | |||
| No mismatch, No./total (%) [reference] | 2/8 (25.0) | 4/21 (19.0) | |
| Mismatch, No./total (%) | 64/162 (39.5) | 26/145 (17.9) | |
| Effect size with uncertainty estimates | aRR, 1.04 (95% CI, 0.26 to 4.21) aRD, 0.010 (95% CI, −0.344 to 0.364) |
aRR, 0.49 (95% CI, 0.22 to 1.05) aRD, –0.139 (95% CI, −0.289 to 0.012) |
.47 |
| Complete dependence or death (mRS 5-6b) | |||
| No mismatch, No./total (%) [reference] | 3/8 (37.5) | 14/21 (66.7) | |
| Mismatch, No./total (%) | 74/162 (45.7) | 87/145 (60.0) | |
| Effect size with uncertainty estimates | aRR, 1.33 (95% CI, 0.52 to 3.44) aRD, 0.178 (95% CI, −0.109 to 0.465) |
aRR, 1.10 (95 % CI, 0.78 to 1.56) aRD, 0.075 (95% CI, −0.129 to 0.279) |
.65 |
| Presence of mismatch profile (mismatch volume ≥15 mL and mismatch ratio ≥1.8)—based on CTP/MRI core volume | |||
| mRS distributionb | |||
| No mismatch, median (IQR) [reference] | 5 (4-6) [n = 59] | 5 (4-6) [n = 61] | |
| Mismatch, median (IQR) | 4 (2-6) [n = 111] | 5 (4-6) [n = 105] | |
| Effect size with uncertainty estimates | aGenOR, 0.89 (95% CI, 0.57 to 1.38) | aGenOR, 0.92 (95% CI, 0.63 to 1.32) | .92 |
| Functional independence (mRS 0-2b) | |||
| No mismatch, No./total (%) [reference] | 6/59 (10.2) | 2/61 (3.3) | |
| Mismatch, No./total (%) | 28/111 (25.2) | 10/105 (9.5) | |
| Effect size with uncertainty estimates | aRR, 1.20 (95% CI, 0.44 to 3.28) aRD, 0.033 (95% CI, −0.124 to 0.191) |
aRR, 1.09 (95% CI, 0.26 to 4.57) aRD, 0.003 (95% CI, −0.097 to 0.103) |
.75 |
| Independent ambulation (mRS 0-3b) | |||
| No mismatch, No./total (%) [reference] | 14/59 (23.7) | 6/61 (9.8) | |
| Mismatch, No./total (%) | 52/111 (46.8) | 24/105 (22.9) | |
| Effect size with uncertainty estimates | aRR, 1.03 (95% CI, 0.56 to 1.88) aRD, 0.009 (95% CI, −0.164 to 0.181) |
aRR, 0.87 (95% CI, 0.39 to 1.92) aRD, −0.032 (95% CI, −0.155 to 0.090) |
.60 |
| Complete dependence or death (mRS 5-6b) | |||
| No mismatch, No./total (%) [reference] | 31/59 (52.5) | 43/61 (70.5) | |
| Mismatch, No./total (%) | 46/111 (41.4) | 58/105 (55.2) | |
| Effect size with uncertainty estimates | aRR, 1.18 (95% CI, 0.82 to 1.70) aRD, 0.092 (95% CI, −0.071 to 0.255) |
aRR, 1.05 (95% CI, 0.79 to 1.38) aRD, 0.037 (95% CI, −0.117 to 0.191) |
>.99 |
Abbreviations: aRD, absolute risk difference; aRR, absolute risk reduction; CT, computed tomography; MRI, magnetic resonance imaging; mRS, modified Rankin Scale.
a
Analyses are adjusted for age, National Institutes of Health Stroke Scale score, time from last known well to randomization, and CT perfusion/MRI core volume. aGenOR greater than 1 indicates better functional outcome (distribution of mRS score) at 90-day follow-up with endovascular thrombectomy. aRR greater than 1 indicates higher rate ratio for mRS 0-2, 0-3, and 5-6 with endovascular thrombectomy.
b
mRS is a 7-level ordinal scoring system representing functional status, with higher scores representing worse functional status (0 indicating without any deficits and 6 indicating dead).