External validation of clinical risk prediction score for elderly treated with endovascular thrombectomy.

Autor: Enriquez BAB; Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Skattør TH; Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Laugesen NG; Department of Neurology, Stroke Center Rigshospitalet, Copenhagen, Denmark., Truelsen T; Department of Neurology, Stroke Center Rigshospitalet, Copenhagen, Denmark.; Faculty of Health and Medical Sciences, The University of Copenhagen, Copenhagen, Denmark., Lund CG; Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway., Nome T; Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway., Beyer MK; Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Skjelland M; Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Aamodt AH; Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. a.h.aamodt@medisin.uio.no.; Department of Neuromedicine and Movement Science, The Norwegian University of Science and Technology, Trondheim, Norway. a.h.aamodt@medisin.uio.no.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2024 Jul 02. Date of Electronic Publication: 2024 Jul 02.
DOI: 10.1007/s00415-024-12535-6
Abstrakt: Background and Aim: The thrombectomy in the elderly prediction score (TERPS) for functional outcome after anterior circulation endovascular therapy (EVT) in patients ≥ 80 years was recently developed. The aim of this study was to assess predictors of functional outcome in the elderly and validate the prediction model.
Methods: Consecutive patients treated with EVT from the Oslo Acute Reperfusion Stroke Study were evaluated for inclusion. Clinical and radiological parameters were used to calculate the TERPS, and functional outcome were assessed at 3-month follow-up.
Results: Out of 1028 patients who underwent EVT for acute ischemic stroke from January 2017 to July 2022, 218 (21.2%) patients ≥ 80 years with anterior ischemic stroke were included. Fair outcome, defined as modified Rankin scale ≤ 3 (mRS), was achieved in 117 (53.7%). In bivariate analyses, male sex (p 0.035), age (p 0.025), baseline National Institute of Health Stroke Scale (NIHSS, p < 0.001), pre-stroke mRS (p 0.002) and Alberta Stroke Program Early Computed Tomography score (ASPECTS, p 0.001) were associated with fair outcome. Significant predictors for fair outcome in regression analyses were lower pre-stroke mRS, adjusted odd ratio, (aOR) 0.67 (95% CI 0.50-0.91, p 0.01), NIHSS, aOR 0.92 (95% CI 0.87-0.97, p 0.002), and higher ASPECTS, aOR 1.22 (95% CI 1.03-1.44, p 0.023). The area under the curve (AUC) using TERPS was 0.74 (95% CI 0.67-0.80).
Conclusions: The risk prediction score TERPS showed moderate performance in this external validation. Other variables may still be included to improve the model and validation using other cohorts is recommended.
Trial Registration: NCT06220981.
(© 2024. The Author(s).)
Databáze: MEDLINE
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