Alberta Stroke Program Early CT Score-Time Score Predicts Outcome after Endovascular Therapy in Patients with Acute Ischemic Stroke: A Retrospective Single-Center Study

作者：Todo Kenichi^*; Sakai Nobuyuki; Kono Tomoyuki; Hoshi Taku; Imamura Hirotoshi; Adachi Hidemitsu; Yamagami Hiroshi; Kohara Nobuo

来源：Journal of Stroke and Cerebrovascular Diseases, 2018, 27(4): 1041-1046.

DOI：10.1016/j.jstrokecerebrovasdis.2017.11.007

• Ischemic stroke
• endovascular therapy
• outcome predictive factors
• endovascular recanalization
• revascularization

Background: Clinical outcomes after successful endovascular therapy in patients with acute ischemic stroke are associated with several factors including onset-to-reperfusion time (ORT), the National Institute of Health Stroke Scale (NIHSS) score, and the Alberta Stroke Program Early CT Score (ASPECTS). The NIHSS-time score, calculated as follows: [NIHSS score] x [onset-to-treatment time (h)] or [NIHSS score] x [ORT (h)], has been reported to predict clinical outcomes after intravenous recombinant tissue plasminogen activator therapy and endovascular therapy for acute stroke. The objective of the current study was to assess whether the combination of the ASPECTS and the ORT can predict the outcomes after endovascular therapy.Methods: The charts of 117 consecutive ischemic stroke patients with successful reperfusion after endovascular therapy were retrospectively reviewed. We analyzed the association of ORT, ASPECTS, and ASPECTS-time score with clinical outcome. ASPECTS-time score was calculated as follows: [11 - ASPECTS] x [ORT (h)]. Results: Rates of good outcome for patients with ASPECTS-time scores of tertile values, scores 5.67 or less, scores greater than 5.67 to 10.40 or less, and scores greater than 10.40, were 66.7%, 56.4%, and 33.3%, respectively (P < .05). Ordinal logistic regression analysis showed that the ASPECTS-time score (per category increase) was an independent predictor for better outcome (common odds ratio:.374; 95% confidence interval:.150-0.930; P < .05). Conclusions: A lower ASPECTS-time score may predict better clinical outcomes after endovascular treatment.

• 出版日期2018-4