Simple variables predict miserable outcome after intravenous thrombolysis.
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| Title: | Simple variables predict miserable outcome after intravenous thrombolysis. |
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| 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] |
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| Database: | Psychology and Behavioral Sciences Collection |
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