Development and validation of muscle strength improvement in 24 hours to predict ischemic stroke patients’ outcome after endovascular therapy: A retrospective cohort study

The relationship between muscle strength improvement and ischemic stroke outcome following endovascular therapy (EVT) for emergency treatment of patients has not been well studied. We developed the prognostic value of the change in muscle strength scores on the Medical Research Council (MRC) scale within 24 hours of EVT as a predictor of EVT outcomes. We retrospectively analyzed prospectively collected data from 142 consecutive patients with ischemic stroke who underwent EVT between August 2018 and February 2022 at a comprehensive stroke center. Early muscle strength improvement (EMSI) was defined as 3 levels of muscle strength improvement on the MRC scale or improvement to grade 4 or 5 of lower-limb muscle strength (LLMS) 24 ± 8 h after EVT. A favorable outcome was defined as a 3-months outcome of the modified Rankin scale (mRS) 0% to 2. 84.2% of EMSI patients had a favorable outcome, in comparison to only 21.2% of non-EMSI patients (P < .001). Similarly, 47.1% of patients died at 3-months in the non-EMSI group, while a significantly lower mortality (8.8%) was observed in the EMSI group (P < .001). LLMS 24 hours post-EVT was significantly associated with 90-day outcomes (P < .001). Early muscle strength improvement in the emergency setting may be a useful predictor of a desired functional outcome in patients with large-vessel occlusion stroke following EVT.