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A simple clinical and MRI scale to predict good outcome in t-PA patients
- Source :
- Neurological Research. 33:1038-1043
- Publication Year :
- 2011
- Publisher :
- Informa UK Limited, 2011.
-
Abstract
- The frequency of good outcome at 3 months after tissue plasminogen activator (t-PA) therapy is ∼35%. The present study aimed to devise a simple scale to predict good outcome using clinical factors and magnetic resonance imaging (MRI) findings before and immediately after t-PA infusion.Consecutive patients with acute ischemic stroke treated with t-PA within 3 hours of stroke onset were studied prospectively. We assessed clinical factors independently associated with good outcome [modified Rankin scale (mRS): 0-1] at 3 months after t-PA therapy. We created a simple scale to predict good outcome in t-PA patients using factors selected by multivariate logistic regression analysis.Subjects comprised 105 patients (69 men; median age, 74 years). Multivariate logistic regression analysis revealed the following independent factors associated with good outcome: baseline National Institutes of Health Stroke Scale (NIHSS)11 [odds ratio (OR), 13·64; 95% confidence interval (CI), 3·588-51·822; P = 0·0001], glucose150 mg/dl (OR, 3·76; 95%CI, 1·014-13·963; P = 0·0475), and early recanalization within 1 hour after t-PA infusion (OR, 5·28; 95%CI, 1·179-23·656; P = 0·0296). Those three variables were selected for use in the good outcome scale, with NIHSS11 as 2 points, glucose150 mg/dl as 1 point, and early recanalization as 1 point. Frequencies of patients with good outcome for each score were as follows: score 0, 0·0%; score 1, 7·1%; score 2, 43·5%; score 3, 65·4%; and score 4, 71·4%. The C statistic for the score was 0·849 (95%CI, 0·776-0·922).A simple clinical and MRI scale can predict good outcome in t-PA patients.
- Subjects :
- Male
medicine.medical_specialty
Scale (ratio)
Logistic regression
Tissue plasminogen activator
Brain Ischemia
Fibrinolytic Agents
Predictive Value of Tests
Modified Rankin Scale
Internal medicine
medicine
Humans
Prospective Studies
Good outcome
Aged
Aged, 80 and over
medicine.diagnostic_test
business.industry
Stroke scale
Magnetic resonance imaging
General Medicine
Odds ratio
Middle Aged
Magnetic Resonance Imaging
Surgery
Stroke
Neurology
Tissue Plasminogen Activator
Female
Neurology (clinical)
business
medicine.drug
Subjects
Details
- ISSN :
- 17431328 and 01616412
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Neurological Research
- Accession number :
- edsair.doi.dedup.....7b6a9a62111f92996e3c83ce49c11a38