Prognostic yield of imaging before and after recanalization treatments in ischemic stroke

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Ferraz, B (Author) Other; Ricardo Reis (Author) FMUP; Rocha, ALC (Author) Other; Moreira, G (Author) Other; Fonseca, L (Author) Other; Parreira, T (Author) Other; Elsa Azevedo (Author) FMUP; Pedro Castro (Author) FMUP

Journal

Title: Acta Neurologica Scandinavica

Vol. 141

Pages: 226-235

ISSN: 0001-6314

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 1 Citation

Scopus - 0 Citations

Other information

Authenticus ID: P-00R-MNX

DOI: 10.1111/ane.13208

Abstract (EN): Objectives The scores to predict outcome in ischemic stroke were validated prior to the approval of modern revascularization treatments. We evaluated the accuracy of pre and post-treatment models in a recent recanalization therapy cohort and whether radiological and ultrasound findings could improve their accuracy. Material & Methods We included 375 anterior circulation ischemic stroke patients treated with intravenous thrombolysis or thrombectomy during 2017 and 2018. We collected demographic, clinical, and imaging data. We built pre and post-treatment logistic regression models to predict independence (modified Rankin Scale 0-2) at 3 months. The models included the Alberta Stroke Program Early CT Score (ASPECTS), infarct volume (ABC/2 method), and the Thrombolysis in Brain Ischemia (TIBI) ultrasonographic grade of recanalization. We compared areas under the receiver operating characteristic curve (AUC). Results Our preintervention model, combining neurological deficit severity, age, and admission glycemia, was not improved by the inclusion of ASPECTS (AUC 0.80 vs 0.79, P = .28). Early neurological recovery at 24-hour significantly increased prognostic performance (AUC = 0.85, P < .01), which did not change by adding final infarct volume or the persistence of arterial occlusion of the affected territory (AUC = 0.86 and 0.85, P > .05). Conclusions Models that combine simple variables such as neurological deficit severity, age, and admission glycemia were the most useful for predicting functional outcome in ischemic stroke patients submitted to revascularization treatments. Pre and post-treatment imaging findings did not enhance prognostic accuracy when compared to the patient's clinical improvement.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10