1. TOAST vs. ASCOD: Sunt importante criteriile de clasificare în accidentul vascular cerebral ischemic de cauză nedeterminată?
- Author
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Râzvan, R., Terecoasă, E., Grecu, N., and Tiu, C.
- Abstract
Introduction. Ischemic stroke is a heterogeneous disorder w ith more than 100 pathologies implicated in Us pathogenesis and therefore a reliable etiologic classification of this disease is highly important. TOAST classification is widely used in clinical practice but 25-40% o f strokes are Classified as undetermined. ASCOD classification describes individual phenotypes comprising all pathologies potentially implicated in strobe development, thus minimizing strokes of truly undetermined cause. Methods. The aim of this study was to investigate ASCOD evidence grades in TOAST-undetermined strokes. We performed a retrospective analysis of prospectively collected data about 547 patients consecutively hospitalized for acute ischemic stroke. Strokes were classified according to both ASCOD and TOAST criteria. Results. According to TOAST criteria, 36% of patients were included in the undetermined subgroup: 89.7% due to incomplete evaluation, 6.7% due to tw o or more causes identified and 3.6% due to lack of evidence of any potential cause despile complete work-up. At least one ASCOD evidence grade (1,2 or 3) was identified in 37,31% of patients classified as TOAST-undetermined. in 14,29% of patients classified as TOAST-undetermined despite complete workup and in i2,99% of patients classified as TOAST-undetermined due to incomplete evaluation was identified at least one ASCOD grade 1 or 2 .71,5% of patients w ith TOAST undetermined strokes (due to both complete and incomplete evaluation] were assigned at least one ASCOD grade 3. Conclusion. The phenotypic ASCOD classification retains more relevant information regarding potential causes of stroke in TOAST undetermined patients, thus offering valuable data regarding secondary prevention strategies and adequate follow-up. [ABSTRACT FROM AUTHOR]
- Published
- 2017