Higher Baseline Cortical Score Predicts Good Outcome in Patients With Low Alberta Stroke Program Early Computed Tomography Score Treated with Endovascular Treatment.

Autor:	Xing PF; Department of Neurology, Changhai Hospital, Naval Medical University, Shanghai, China., Zhang YW; Department of Neurology, Changhai Hospital, Naval Medical University, Shanghai, China., Zhang L; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Li ZF; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Shen HJ; Department of Neurology, Changhai Hospital, Naval Medical University, Shanghai, China., Zhang YX; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Li H; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Hua WL; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Liu P; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Liu P; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Yang PF; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Hong B; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China., Deng BQ; Department of Neurology, Changhai Hospital, Naval Medical University, Shanghai, China., Liu JM; Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2021 Feb 16; Vol. 88 (3), pp. 612-618.
DOI:	10.1093/neuros/nyaa472
Abstrakt:	Background: Patients with large vessel occlusion and noncontrast computed tomography (CT) Alberta Stroke Program Early CT Score (ASPECTS) <6 may benefit from endovascular treatment (EVT). There is uncertainty about who will benefit from it. Objective: To explore the predicting factors for good outcome in patients with ASPECTS <6 treated with EVT. Methods: We retrospectively reviewed 60 patients with ASPECTS <6 treated with EVT in our center between March 2018 and June 2019. Patients were divided into 2 groups because of the modified Rankin Score (mRS) at 90 d: good outcome group (mRS 0-2) and poor outcome group (mRS ≥3). Baseline and procedural characteristics were collected for unilateral variate and multivariate regression analyses to explore the influent variates for good outcome. Results: Good outcome (mRS 0-2) was achieved in 24 (40%) patients after EVT and mortality was 20% for 90 d. Compared with the poor outcome group, higher baseline cortical ASPECTS (c-ASPECTS), lower intracranial hemorrhage, and malignant brain edema after thrombectomy were noted in the good outcome group (all P < .01). Multivariate logistic regression showed that only baseline c-ASPECTS (≥3) was positive factor for good outcome (odds ratio = 4.29; 95% CI, 1.21-15.20; P = .024). The receiver operating characteristics curve indicated a moderate value of c-ASPECTS for predicting good outcome, with the area under receiver operating characteristics curve 0.70 (95% CI, 0.56-0.83; P = .011). Conclusion: Higher baseline c-ASPECTS was a predictor for good clinical outcome in patients with ASPECTS <6 treated with EVT, which could be helpful to treatment decision. (Copyright © 2020 by the Congress of Neurological Surgeons.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu