• Jacqueline A Frank, Kara Jo Swafford, Jill M Roberts, Amanda L Trout, Ann M Stowe, Douglas E Lukins, Stephen Grupke, Keith R Pennypacker, and Justin F Fraser.
• Department of Neurology, University of Kentucky, Lexington, Kentucky, USA; Center for Advanced Translational Stroke Science, University of Kentucky, Lexington, Kentucky, USA.
• World Neurosurg. 2021 Sep 1; 153: e365-e372.

ObjectiveIschemic stroke is the fifth leading cause of death in the United States. Smoking accelerates the onset of stroke by 10 years. The effects of smoking status on percent change in National Institutes of Health Stroke Scale (NIHSS) score, infarct volume, and edema volume were examined following mechanical thrombectomy for large vessel occlusion in patients with acute ischemic stroke.MethodsSubjects (N = 90; >18 years old) were divided into 3 groups based on smoking status: current smokers, previous smokers (defined as having quit >6 months before the ischemic event), and nonsmokers. Percent change in NIHSS score was defined as score at admission minus score at discharge divided by score at admission and was used as a predictor of functional outcome. Linear regression analysis was performed based on infarct or edema volume versus percent change in NIHSS score and separated by sex.ResultsConsistent with previous findings, smokers experienced a stroke 10 years earlier than nonsmokers (P = 0.004). Statistically significant linear regressions existed between infarct volume or edema volume in relation to worsening change in NIHSS score with female smokers only. Stroke-induced tissue damage, as measured by magnetic resonance imaging or computed tomography, was predictive of functional recovery only in female smokers.ConclusionsThese findings are valuable for patient counseling, particularly for women, for smoking cessation.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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