Predictors of Outcome in Patients with Acute M2 Occlusion (P7.149)

OBJECTIVE: The aim of our study was to assess for factors associated with outcome following M2 middle cerebral artery occlusion infarcts. BACKGROUND: Limited information is available regarding the outcomes after distal middle cerebral artery stroke specially when they are not treated with IV thrombolysis or IA therapy. DESIGN/METHODS: We retrospectively reviewed admission CTA of consecutive acute ischemic stroke patients admitted to a single academic center from January 2010 to August 2012. Patients with isolated M2 occlusion were included. We assessed for factors associated with a good 90-day outcome (modified Rankin Scale [mRS] score ≤2). Factors associated with an mRS ≤2 in univariable analyses (p RESULTS: 90 patients with isolated M2 occlusions were included in final analyses. Of these, 69% had a 90-day mRS ≤2. Age ≤80 years (OR 0.37, 95%-CI 0.003-0.416, p=0.008), aNIHSS ≤10 (OR 0.05, 95%-CI 0.009-0.36, p=0.002), and infarct volume <27 ml (OR 0.009, 95%-CI 0.001-0.15, p=0.001) were independent predictors of a good 90-day outcome. Entering age, aNIHSS, and infarct volume as continuous variables did not meaningfully change these results. Notably, 20% patients (64% of those with a poor outcome) had died by 90-days. We then repeated all analyses for predictors of 90-day mortality. This analysis indicated that age ≤80 years (OR 4.7, 95%-CI 1.25-18, p=0.02) and infarct volume <26 ml (OR 7.3, 95%-CI 1.4-38.5, p<0.001) were independently associated with 90-day mortality. CONCLUSIONS: The majority of patients with isolated M2 occlusion strokes have a good 90-day outcome, which is predicted by younger age, lower aNIHSS, and smaller infarct size. Further investigations are required to identify specific factors predicting death in this patient population. Disclosure: Dr. Khan has nothing to disclose. Dr. Zhang has nothing to disclose. Dr. Moonis has nothing to disclose. Dr. Goddeau has nothing to disclose. Dr. Henninger has received personal compensation for activities with Brainsgate as a consultant.