Huaiming Wang1, Meng Zhang2, Yonggang Hao3, Wenjie Zi4, Dong Yang4, Zhiming Zhou5, Yu Geng6, Zhen Wang7, Hua Li8, Gelin Xu4, Graeme J Hankey9, Yunyun Xiong10, Xinfeng Liu11. 1. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; Department of Neurology, The 89th Hospital of The People's Liberation Army, Weifang, China. 2. Department of Neurology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Yuzhong, China. 3. Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China; Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. 4. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. 5. Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, China. 6. Department of Neurology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China. 7. Department of Neurology, Changsha Central Hospital, Changsha, China. 8. Department of Neurology, The 476th Hospital of The People's Liberation Army, Fuzhou, China. 9. Medical School, The University of Western Australia, Perth, Western Australia, Australia. 10. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: caloriey@163.com. 11. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: xfliu2@vip.163.com.
Abstract
OBJECTIVE: Successful recanalization (SR) of the occluded artery does not always translate into a good outcome for patients with acute anterior circulation large-vessel occlusion stroke. This study aimed to develop a scale to predict poor outcome early despite SR after endovascular treatment (EVT) for candidates identified using current guidelines. METHODS: The eligible patients with SR were retrospectively enrolled between 2014 and 2016. Poor outcome was defined as modified Rankin Scale of 3 to 6 at 90 days. Multivariable logistic regression was used to derive a PooR outcomE of enDovascular treatment wIth suCcessful recanalizaTion (PREDICT) scale. The discrimination and calibration of the scale were assessed. RESULTS: A total of 332 patients were enrolled. The PREDICT scale consisted of 5 items (prior intravenous thrombolysis, collateral status, blood glucose, blood neutrophil-to-lymphocyte ratio, and baseline National Institutes of Health Stroke Scale score). The scale had good discrimination and calibration. The risk of poor outcome was stratified into very low (PREDICT scale score ≤5), low (6-8), moderate (9-11), and high (≥12). Compared with patients with a score of ≤5, patients with a score of ≥12 had an 18.33-fold (95% confidence interval [CI], 6.36-52.89) increased risk of poor outcome. CONCLUSIONS: The PREDICT scale is a practical tool for early prediction of poor outcome despite SR after EVT in our patients and, if validated in other patient populations, may serve as a scale for identifying which patients are most, and least, likely to benefit from EVT.
OBJECTIVE: Successful recanalization (SR) of the occluded artery does not always translate into a good outcome for patients with acute anterior circulation large-vessel occlusion stroke. This study aimed to develop a scale to predict poor outcome early despite SR after endovascular treatment (EVT) for candidates identified using current guidelines. METHODS: The eligible patients with SR were retrospectively enrolled between 2014 and 2016. Poor outcome was defined as modified Rankin Scale of 3 to 6 at 90 days. Multivariable logistic regression was used to derive a PooR outcomE of enDovascular treatment wIth suCcessful recanalizaTion (PREDICT) scale. The discrimination and calibration of the scale were assessed. RESULTS: A total of 332 patients were enrolled. The PREDICT scale consisted of 5 items (prior intravenous thrombolysis, collateral status, blood glucose, blood neutrophil-to-lymphocyte ratio, and baseline National Institutes of Health Stroke Scale score). The scale had good discrimination and calibration. The risk of poor outcome was stratified into very low (PREDICT scale score ≤5), low (6-8), moderate (9-11), and high (≥12). Compared with patients with a score of ≤5, patients with a score of ≥12 had an 18.33-fold (95% confidence interval [CI], 6.36-52.89) increased risk of poor outcome. CONCLUSIONS: The PREDICT scale is a practical tool for early prediction of poor outcome despite SR after EVT in our patients and, if validated in other patient populations, may serve as a scale for identifying which patients are most, and least, likely to benefit from EVT.
Authors: Fawaz Al-Mufti; Priyank Khandelwal; Tolga Sursal; Jared B Cooper; Eric Feldstein; Krishna Amuluru; Jayaji M Moré; Ambooj Tiwari; Amit Singla; Adam A Dmytriw; Mariangela Piano; Luca Quilici; Guglielmo Pero; Leonardo Renieri; Nicola Limbucci; Mario Martínez-Galdámez; Miguel Schüller-Arteaga; Jorge Galván; Juan Francisco Arenillas-Lara; Zafar Hashim; Sanjeev Nayak; Keith Desousa; Hai Sun; Pankaj K Agarwalla; J Sudipta Roychowdhury; Emad Nourollahzadeh; Tannavi Prakash; Andrew R Xavier; J Diego Lozano; Gaurav Gupta; Dileep R Yavagal; Mohammad Elghanem; Chirag D Gandhi; Stephan A Mayer Journal: Interv Neuroradiol Date: 2022-04-11 Impact factor: 1.610
Authors: Xiaohao Zhang; Kang Yuan; Huaiming Wang; Pengyu Gong; Teng Jiang; Yi Xie; Lei Sheng; Dezhi Liu; Xinfeng Liu; Gelin Xu Journal: J Am Heart Assoc Date: 2020-01-24 Impact factor: 5.501