A Pre-Intervention 4-Item Scale for Predicting Poor Outcome Despite Successful Recanalization in Basilar Artery Occlusion

AbstractPoor outcome despite successful recanalization is a relatively common occurrence after endovascular therapy (EVT) in acute intracranial large vessel occlusion. We aimed to develop a simple pre-intervention scale with readily available indicators for predicting the 90-day poor outcome in acute basilar artery occlusion (BAO) patients with successful recanalization after EVT. A prospectively registered consecutive cohort of acute BAO patients treated with EVT in a tertiary stroke center during a 6-year period was reviewed. Poor outcome despite successful recanalization was defined as a 90-day mRS of>  3 despite a post-intervention mTICI of ≥ 2b. A logistic regression analysis was employed to develop the predictive scale. The performance of the scale was estimated by ROC curve and Hosmer-Lemeshow test. Poor outcome was observed in 48 of 109 patients included in this study. The proposed scal e consisted of four selected pre-intervention predictors, including the NIHSS score, Pons-Midbrain Index (PMI), bilateral thalamic infarction, and Basilar Artery on Computed Tomography Angiography (BATMAN) collateral score. The 4-item scale revealed good discrimination with an area under curve of 0. 83 (95% CI = 0.75–0.90) and acceptable calibration assessed by Hosmer-Lemeshow test (P = 0.48). The optimal cutoff value of the scale (range 0–5 points) was ≥ 3 points with 77% sensitivity, 80% specificity, and 79% accuracy. As a pre-intervention predictive model, t...
Source: Translational Stroke Research - Category: Neurology Source Type: research