Novel Risk Score to Predict Poor Outcome After Endovascular Treatment in Anterior Circulation Occlusive Acute Ischemic Stroke

 This is the problem, predicting failure to recover rather than DELIVERING RECOVERY! I'd have you all fired!

Novel Risk Score to Predict Poor Outcome After Endovascular Treatment in Anterior Circulation Occlusive Acute Ischemic Stroke

Dong Yang, MD https://orcid.org/0000-0002-2695-0499, Kang Yuan, MD https://orcid.org/0000-0002-4482-2503, Wusheng Zhu, MD, PhD, Min Lin, MD, PhD https://orcid.org/0000-0002-6865-5148 35604214@qq.com, and Xinfeng Liu, MD, PhD https://orcid.org/0000-0002-8182-9632 xfliu2@vip.163.comAuthor Info & Affiliations

Journal of the American Heart Association

New online

https://doi.org/10.1161/JAHA.124.036329

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Abstract

Background

We aimed to develop and validate a prognostic score to predict outcomes after endovascular treatment in acute ischemic stroke.

Methods

The prognostic score was developed based on the ACTUAL (Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke) registry. The validation cohort was derived from the Captor trial. Independent predictors of poor outcome after endovascular treatment were obtained from the least absolute shrinkage and selection operator regression and multivariable logistic regression. Corresponding regression coefficients were used to generate point scoring system. The area under the receiver operating characteristic curve and the Hosmer–Lemeshow goodness‐of‐fit test were used to assess model discrimination and calibration. The predictive properties of the developed prognostic score were validated and the discriminative power was compared with other validated tools.

Results

A 17‐point Age, Collateral Status, Blood glucose, Alberta Stroke Program Early Computed Tomography Score, and National Institutes of Health Stroke Scale score scale was developed from the set of independent predictors, including age, admission National Institutes of Health Stroke Scale score, Alberta Stroke Program Early Computed Tomography Score on initial computed tomography scan, blood glucose, and collateral status. The scale showed good discrimination in the derivation cohort (area under the receiver operating characteristic curve, 0.79 [95% CI, 0.75–0.82]) and validation cohorts (area under the receiver operating characteristic curve, 0.77 [95% CI, 0.70–0.84]). The scale was well calibrated (Hosmer–Lemeshow test) in the derivation cohort (P=0.57) and validation cohort (P=0.75).

Conclusions

The Age, Collateral Status, Blood glucose, Alberta Stroke Program Early Computed Tomography score, and National Institutes of Health Stroke Scale score scale is a valid tool for predicting outcomes and may be useful for endovascular stroke treatment in anterior circulation large vessel occlusions.