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Simple variables predict miserable outcome after intravenous thrombolysis.

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Title: Simple variables predict miserable outcome after intravenous thrombolysis.
Authors: Seiffge, D. J., Karagiannis, A., Strbian, D., Gensicke, H., Peters, N., Bonati, L. H., Kotisaari, K., Leppä, M., Kejda‐Scharler, J., Tränka, C., Ginsbach, P., Tatlisumak, T., Lyrer, P. A., Engelter, S. T.
Source: European Journal of Neurology. Feb2014, Vol. 21 Issue 2, p185-191. 7p.
Subjects: Thrombolytic therapy, Glasgow Coma Scale, Stroke, Cerebrovascular disease, Confidence intervals
Abstract: Background and purpose To test the predictability of miserable outcome amongst ischaemic stroke patients receiving intravenous thrombolysis ( IVT) based on a simple variables model ( SVM) and to compare the model's predictive performance with that of an existing score which includes imaging and laboratory parameters ( DRAGON). Methods The SVM consists of the parameters age, independence before stroke, normal Glasgow coma verbal score, able to lift arms and able to walk. In a derivation cohort ( n = 1346) and a validation cohort ( n = 638) of consecutive IVT-treated stroke patients, the probability estimated by SVM and the observed occurrence of miserable 3-month outcome (modified Rankin score 5-6) were compared. The performances of SVM and the DRAGON score were compared. The area under the receiver operating curve ( AUC) (95% confidence interval, CI) and the bootstrapping approach were used to compare the predictive performance. Results The AUCs to predict miserable outcome in the derivation cohort were 0.807 (95% CI 0.774-0.838) using the SVM and 0.822 (0.790-0.850) using the DRAGON score ( P = 0.3). For the validation cohort, AUCs were 0.786 (0.742-0.829) for the SVM and 0.809 (0.774-0.845) for the DRAGON score ( P = 0.23). Only one patient with an SVM probability of >70% for miserable outcome in either cohort had a good outcome whilst 83% had a miserable outcome. An online SVM calculator to estimate the probability of miserable outcome for individual patients is available under http://www.unispital-basel.ch/ SVM-Tool. Conclusion The SVM was similar in accuracy to the DRAGON score for predicting miserable outcome after IVT. As these simple variables are available already at the pre-hospital stage, the SVM may facilitate and accelerate pre-hospital triage of patients at high risk for miserable outcome after IVT towards endovascular treatment. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Simple variables predict miserable outcome after intravenous thrombolysis.
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  Data: <searchLink fieldCode="AR" term="%22Seiffge%2C+D%2E+J%2E%22">Seiffge, D. J.</searchLink><br /><searchLink fieldCode="AR" term="%22Karagiannis%2C+A%2E%22">Karagiannis, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Strbian%2C+D%2E%22">Strbian, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Gensicke%2C+H%2E%22">Gensicke, H.</searchLink><br /><searchLink fieldCode="AR" term="%22Peters%2C+N%2E%22">Peters, N.</searchLink><br /><searchLink fieldCode="AR" term="%22Bonati%2C+L%2E+H%2E%22">Bonati, L. H.</searchLink><br /><searchLink fieldCode="AR" term="%22Kotisaari%2C+K%2E%22">Kotisaari, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Leppä%2C+M%2E%22">Leppä, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Kejda‐Scharler%2C+J%2E%22">Kejda‐Scharler, J.</searchLink><br /><searchLink fieldCode="AR" term="%22Tränka%2C+C%2E%22">Tränka, C.</searchLink><br /><searchLink fieldCode="AR" term="%22Ginsbach%2C+P%2E%22">Ginsbach, P.</searchLink><br /><searchLink fieldCode="AR" term="%22Tatlisumak%2C+T%2E%22">Tatlisumak, T.</searchLink><br /><searchLink fieldCode="AR" term="%22Lyrer%2C+P%2E+A%2E%22">Lyrer, P. A.</searchLink><br /><searchLink fieldCode="AR" term="%22Engelter%2C+S%2E+T%2E%22">Engelter, S. T.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Feb2014, Vol. 21 Issue 2, p185-191. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Thrombolytic+therapy%22">Thrombolytic therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Glasgow+Coma+Scale%22">Glasgow Coma Scale</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Cerebrovascular+disease%22">Cerebrovascular disease</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Background and purpose To test the predictability of miserable outcome amongst ischaemic stroke patients receiving intravenous thrombolysis ( IVT) based on a simple variables model ( SVM) and to compare the model's predictive performance with that of an existing score which includes imaging and laboratory parameters ( DRAGON). Methods The SVM consists of the parameters age, independence before stroke, normal Glasgow coma verbal score, able to lift arms and able to walk. In a derivation cohort ( n = 1346) and a validation cohort ( n = 638) of consecutive IVT-treated stroke patients, the probability estimated by SVM and the observed occurrence of miserable 3-month outcome (modified Rankin score 5-6) were compared. The performances of SVM and the DRAGON score were compared. The area under the receiver operating curve ( AUC) (95% confidence interval, CI) and the bootstrapping approach were used to compare the predictive performance. Results The AUCs to predict miserable outcome in the derivation cohort were 0.807 (95% CI 0.774-0.838) using the SVM and 0.822 (0.790-0.850) using the DRAGON score ( P = 0.3). For the validation cohort, AUCs were 0.786 (0.742-0.829) for the SVM and 0.809 (0.774-0.845) for the DRAGON score ( P = 0.23). Only one patient with an SVM probability of >70% for miserable outcome in either cohort had a good outcome whilst 83% had a miserable outcome. An online SVM calculator to estimate the probability of miserable outcome for individual patients is available under http://www.unispital-basel.ch/ SVM-Tool. Conclusion The SVM was similar in accuracy to the DRAGON score for predicting miserable outcome after IVT. As these simple variables are available already at the pre-hospital stage, the SVM may facilitate and accelerate pre-hospital triage of patients at high risk for miserable outcome after IVT towards endovascular treatment. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – SubjectFull: Thrombolytic therapy
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      – SubjectFull: Glasgow Coma Scale
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