2023-09-28 14:46:10 +00:00
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abstract: 'BACKGROUND: Strokes in the working-age population represent a relevant
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share of ischemic strokes and re-employment is a major factor for
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well-being in these patients. Income differences by sex have been
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suspected a barrier for women in returning to paid work following
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ischemic stroke. We aim to identify predictors of (not) returning to
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paid work in patients with large vessel occlusion treated with
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mechanical thrombectomy (MT) to identify potential areas of targeted
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vocational rehabilitation.
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METHODS: From 6635 patients enrolled in the German Stroke Registry
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Endovascular Treatment between 2015 and 2019, data of 606 patients of
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the working population who survived large vessel occlusion at least 90
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days past MT were compared based on employment status at day 90
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follow-up. Univariate analysis, multiple logistic regression and
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analyses of area under the curve were performed to identify predictors
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of re-employment.
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RESULTS: We report 35.6\% of patients being re-employed 3 months
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following MT (median age 54.0 years; 36.1\% of men, 34.5\% of women
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{[}P=0.722]). We identified independent negative predictors against
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re-employment being female sex (odds ratio {[}OR], 0.427 {[}95\% CI,
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0.229-0.794]; P=0.007), higher National Institutes of Health Stroke
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Scale (NIHSS) score 24 hours after MT (OR, 0.775 {[}95\% CI,
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0.705-0.852]; P<0.001), large vessel occlusion due to large-artery
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atherosclerosis (OR, 0.558 {[}95\% CI, 0.312-0.997]; P=0.049) and longer
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hospital stay (OR, 0.930 {[}95\% CI, 0.868-0.998]; P=0.043). Positive
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predictors favoring re-employment were excellent functional outcome
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(modified Rankin Scale score of 0-1) at 90 day follow-up (OR, 11.335
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{[}95\% CI, 4.864-26.415]; P<.001) and combined treatment with
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intravenous thrombolysis (OR, 1.904 {[}95\% CI, 1.046-3.466]; P=0.035).
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Multiple regression modeling increased predictive power of re-employment
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status significantly over prediction by best single functional outcome
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parameter (National Institutes of Health Stroke Scale 24 hours after MT
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<= 5; R-2: 0.582 versus 0.432; area under the receiver operating
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characteristic curve: 0.887 versus 0.835, P<0.001).
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CONCLUSIONS: There is more to re-employment after MT than functional
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outcome alone. In particular, attention should be paid to possible
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systemic barriers deterring women from resuming paid work.'
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affiliation: 'Groschel, K (Corresponding Author), Johannes Gutenberg Univ Mainz, Univ
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Med Ctr, Dept Neurol, Langenbeckstr 1, D-55131 Mainz, Germany.
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Hahn, Marianne; Groeschel, Sonja; Hayani, Eyad; Muthuraman, Muthuraman; Groeschel,
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Klaus; Uphaus, Timo, Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Neurol, Langenbeckstr
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1, D-55131 Mainz, Germany.
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Brockmann, Marc A., Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Neuroradiol,
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Mainz, Germany.'
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author: Hahn, Marianne and Groeschel, Sonja and Hayani, Eyad and Brockmann, Marc A.
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and Muthuraman, Muthuraman and Groeschel, Klaus and Uphaus, Timo and Tr, German
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Stroke Registry Endovasc
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author-email: klaus.groeschel@unimedizin-mainz.de
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author_list:
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- family: Hahn
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given: Marianne
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- family: Groeschel
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given: Sonja
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- family: Hayani
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given: Eyad
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- family: Brockmann
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given: Marc A.
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- family: Muthuraman
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given: Muthuraman
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- family: Groeschel
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given: Klaus
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- family: Uphaus
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given: Timo
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- family: Tr
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given: German Stroke Registry Endovasc
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da: '2023-09-28'
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doi: 10.1161/STROKEAHA.121.037386
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eissn: 1524-4628
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files: []
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issn: 0039-2499
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journal: STROKE
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keywords-plus: ISCHEMIC-STROKE; RETURN; WORK; PREDICTORS; SURVIVORS; ADULTS; LIFE
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language: English
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month: AUG
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number: '8'
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number-of-cited-references: '27'
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orcid-numbers: 'Poli, Sven/0000-0002-0286-8781
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Groschel, Klaus/0000-0002-0244-6116
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Dichgans, Martin/0000-0002-0654-387X
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Hahn, Marianne/0000-0002-9462-3844'
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pages: 2528-2537
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papis_id: 3a5fff2d658c586fe0a39434df520f3d
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ref: Hahn2022sexdisparities
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researcherid-numbers: 'Poli, Sven/HLH-8305-2023
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'
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times-cited: '1'
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title: Sex Disparities in Re-Employment in Stroke Patients With Large Vessel Occlusion
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Undergoing Mechanical Thrombectomy
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000828987800026
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usage-count-last-180-days: '0'
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usage-count-since-2013: '3'
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volume: '53'
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web-of-science-categories: Clinical Neurology; Peripheral Vascular Disease
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year: '2022'
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