{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:50:26Z","timestamp":1785297026440,"version":"3.55.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius-Stiftung","doi-asserted-by":"publisher","award":["2022_EKCS.10"],"award-info":[{"award-number":["2022_EKCS.10"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014584","name":"Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014584","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol. Res. Pract."],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Mechanical thrombectomy (MT) is a highly effective treatment for large vessel occlusion (LVO) ischemic stroke. However, a substantial share of patients have lethal outcome within 3\u00a0months. Individualization of outcome prognostication is needed to support clinical decision-making throughout the care pathway after MT. We investigate predictors of lethal outcome in patients with nonfatal LVO, defined by discharge alive from primary treating hospital, in a large prospective registry study of MT under routine care conditions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>6,518 patients with nonfatal LVO treated by MT enrolled in the German Stroke Registry-Endovascular Treatment from May 2015-December 2021 were analysed with regard to lethal outcome by 3\u00a0month follow-up. Univariate group comparisons and multiple logistic regression analysis were performed to identify patients with high odds for survival or lethal outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We report 11.6% (757\/6,518) 3\u00a0month mortality following hospital discharge after LVO treated by MT. Besides better functional outcome at discharge (modified Rankin scale\u2009&lt;\u20094, odds ratio, OR [95% confidence interval, CI]: 2.38 [1.71\u20133.32], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; National Institute of Health Stroke scale\u2009&lt;\u20098, OR [95%CI]: 3.45 [2.55\u20134.66], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), intravenous thrombolysis (OR [95%CI]: 1.48 [1.17\u20131.88], <jats:italic>p<\/jats:italic>\u2009=\u20090.001), successful recanalization (OR [95%CI]: 1.43 [1.08\u20131.90], <jats:italic>p<\/jats:italic>\u2009=\u20090.014) and discharge to a neurorehabilitative facility (versus nursing home: OR [95%CI]: 0.39 [0.26\u20130.58], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; versus home: OR [95%CI]: 0.69 [0.49\u20130.97], <jats:italic>p<\/jats:italic>\u2009=\u20090.032) were independent predictors of survival. Predictors of lethal outcome were older age (OR [95%CI]: 1.09 [1.07\u20131.10], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), male sex (OR [95%CI]: 1.24 [1.00\u20131.55], <jats:italic>p<\/jats:italic>\u2009=\u20090.049), premorbid disability (OR [95%CI]: 1.47 [1.08\u20132.02], <jats:italic>p<\/jats:italic>\u2009=\u20090.016), active smoking (OR [95%CI]: 1.51 [1.06\u20132.14], <jats:italic>p<\/jats:italic>\u2009=\u20090.023), anticoagulation therapy prior to LVO (OR [95%CI]: 1.45 [1.09\u20131.92], <jats:italic>p<\/jats:italic>\u2009=\u20090.010), stroke etiology, general anaesthesia during MT (OR [95%CI]: 1.31 [1.02\u20131.69], <jats:italic>p<\/jats:italic>\u2009=\u20090.035) and intracerebral haemorrhage (OR [95%CI]: 1.50 [1.13\u20131.99], <jats:italic>p<\/jats:italic>\u2009=\u20090.005).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Lethal outcome after hospital discharge within 3\u00a0months after MT is frequent, accounting for more than one quarter of overall 3-month mortality after MT of LVO. Predictors of survival enable individual outcome prognostication, which assists clinical decision-making with regard to surveillance concerning complications, rehabilitative resource allocation and counselling about goals of care.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>ClinicalTrials.gov (Identifier: NCT03356392, Date of registration: 2017\/11\/22).<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s42466-025-00427-7","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T13:48:23Z","timestamp":1759326503000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mortality within three months after nonfatal ischemic stroke treated by mechanical thrombectomy in routine care\u2014data from the German Stroke 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The German Stroke Registry\u2013Endovascular Treatment (GSR-ET) is registered at ClinicalTrials.gov (Identifier: NCT03356392, date of registration: 2017\/11\/22) and was approved by the ethics committee of the leading center (Ludwig-Maximilians University Munich, protocol number: 689\u201315) and by the local ethics committees. Written informed consent was obtained from all participants (or guardians of participants).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AEO: speakers bureau and research grants from Canon medical. KG: personal fees and\/or non-financial support from Abbott Medical, Boehringer Ingelheim, Bristol-Meyers Squibb and Pfizer Pharma GmbH. TU: personal fees from Merck Serono and Pfizer, grants from Else Kr\u00f6ner-Fresenius Stiftung. All other authors report no disclosures relevant to the manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"71"}}