Abstract 2933: Combined Clinical, CT, And CTA-SI Scale To Expect The Presence Of Large Infarct Volume On DWI In Acute Stroke Patients Within 8h Of Onset.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Junya Aoki ◽  
Yohei Tateishi ◽  
Chirs Cummings ◽  
Muhammad S Hussain ◽  
Ken Uchino
Keyword(s):  
Predictive Value ◽  
Area Under Curve ◽  
Infarct Volume ◽  
Volume Estimation ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Source Imaging ◽  
Nihss Score ◽  
Sensitivity Specificity ◽  
Large Infarct

Background and Purpose: Large ischemic volume (>70-80ml) on diffusion-weighted imaging (DWI) has been associated with a lack of response to early recanalization therapy of acute ischemic stroke. We investigated whether a scale that combines clinical, conventional computed tomography (CT) and CT angiography source imaging (CTA-SI) information can estimate large infarct of >80ml seen on early DWI. Methods: Acute anterior circulation stroke patients within 8h of onset and examined with CT and CTA were prospectively enrolled. Only imaging findings evaluated within 1.5h interval among CT, CTA and DWI were analyzed. NIH Stroke Scale (NIHSS) score was assessed on admission. The Alberta Stroke Programme Early CT Score (ASPECTS) was scored on CT and CTA-SI. To devise the early infarct volume estimation scale, NIHSS score, CT and CTA-SI ASPECTSs were scored as 1, if the NIHSS score was greater than or equal to, and, CT and CTA-SI ASPECTS was smaller than or equal to the cut-off value to distinguish the DWI volume of >80ml from others. Collateralization was also defined as score of 1 if collateral filling was limited <50% on CTA-SI. We compared the DWI volume based on the scale, score of 0, 1, 2, 3 and 4. After that, we calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the score to estimate the DWI volume of >80ml were calculated. Result: Fifty-seven subjects (median age [quartiles]; 74 [56-82], male; 28 [49%]) were enrolled from May 2010 to July 2011. DWI volume of >80ml was seen in 10 (18%) patients. Using ROC curve, the cut-off value of NIHSS score to predict DWI of >80ml was 20 (sensitivity of 0.70 and specificity of 0.70, area under curve [AUC] 0.761, p=0.010), that of CT ASPECTS was 6 (sensitivity of 0.98 and specificity of 0.68, AUC 0.887, p<0.001), that of CTA-SI ASPECTS was 6 (sensitivity of 0.87 and specificity of 0.80, AUC 0.952, p<0.001), respectively. Based on the scale, DWI volume was 14 (8-23) ml in patients with score of 0, 22 (11-36) ml with of 1, 67 (36-88) ml with of 2, 127 (71-147) ml with of 3, and 177 (131-191) ml with of 4 (p<0.001). All of those with score of 0 or 1 had DWI volume of ≤80ml (sensitivity of 1.00, specificity of 0.87 PPV of 1.00, and NPV of 0.62 (p<0.001). Seven (54%) of the 13 patients with score of 2 or 3 had DWI volume of >80ml (sensitivity of 0.70, specificity of 0.87, PPV of 0.54, and NPV of 0.93, p<0.001), and all of the 3 patients with score of 4 had DWI volume of >80ml (sensitivity of 0.30, specificity of 1.00, PPV of 1.00, and NPV of 0.87, p=0.004). Conclusion: Clinical and CT based radiological examinations may estimate the large ischemic volume on early DWI.

Abstract 118: Diffusion Lesion Volume Reduction after Recanalization Therapy for Anterior Circulation Stroke with Major Vessel Occlusion: Analysis from the RESCUE-Japan Registry Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Mikito Hayakawa ◽  
Hiroshi Yamagami ◽  
Kazunori Toyoda ◽  
Yuji Matsumaru ◽  
Yukiko Enomoto ◽  
...  
Keyword(s):  
Intravenous Thrombolysis ◽  
Volume Reduction ◽  
Lesion Volume ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Nihss Score ◽  
Median Baseline ◽  
Point Reduction ◽  
Major Vessel

Objective: Although Diffusion-weighted imaging (DWI) lesions are commonly irreversible, DWI lesion volume reduction (DVR) is occasionally observed. We investigated clinical significance and predictors of DVR in acute stroke patients with major vessel occlusion receiving recanalization therapy (RT). Methods: The Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism (RESCUE)-Japan registry prospectively registered 1,442 stroke patients with major vessel occlusion who were admitted to 84 Japanese stroke centers within 24 hours after onset from July 2010 to June 2011. We retrospectively analyzed all patients with the internal carotid artery or middle cerebral artery (M1 or M2 segments occlusions receiving RT and undergoing MRI both on admission and at 24 hours after onset from the registry. We defined DVR as a 1 or more-point reduction of the DWI-Alberta Stroke Program Early CT Score (ASPECTS), and CT-DWI mismatch (CTDM) as a 2 or more-point lower DWI-ASPECTS than CT-ASPECTS on admission. Reperfusion was defined as TICI grade 2b-3 on catheter angiography or modified Mori grade 3 on MRA immediately after RT. Dramatic recovery (DR) was defined as a 10 or more-point reduction or a total NIHSS score of 0-1 at 24 hours, and favorable outcome (FO) defined as a mRS score 0-2 at 3 months. Results: A total of 390 patients (215 men, 72 years old,) was included. Median baseline NIHSS score was 16 (IQR 10-19) and median baseline DWI-ASPECTS was 8 (6-9). CTDM was seen in 92 patients (28%) on admission. Intravenous thrombolysis and endovascular therapy were performed in 246 patients (63%) and 223 patients (57%), respectively. Reperfusion was obtained in 170 patients (51%). DVR was seen in 51 patients (13%). Eighty-eight patients (23%) obtained DR and 158 patients (41%) achieved FO. On multivariate analyses, DVR was significantly related to DR (OR 3.8, 95%CI 1.5-10) and FO (4.6, 1.8-12). CTDM was an independent predictor of DVR (OR 2.5, 95% CI 1.1-5.8). Conclusions: DVR was significantly related to DR and FO. CTDM is a rough predictor of DVR of which area is considered as a “DWI-bright” ischemic penumbra, and might be a useful marker to identify the adequate candidates for RT in spite of relatively large DWI lesions.

Abstract TP315: D-dimer is Associated With 30-day Mortality in Acute Ischemic Stroke With Active Cancer

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ki Woong Nam ◽  
Chi Kyung Kim ◽  
Tae Jung Kim ◽  
Sang Joon An ◽  
Kyungmi Oh ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Infarct Volume ◽  
Hemorrhagic Transformation ◽  
Stroke Patients ◽  
Nihss Score ◽  
Patients With Cancer ◽  
Advanced Stages ◽  
D Dimer ◽  
Active Cancer

Background: Stroke in cancer patients is not rare, but is a devastating event with high mortality. However, the predictors of mortality in stroke patients with cancer have not been well addressed. D-dimer could be a useful predictor because it can reflect both thromboembolic events and advanced stages of cancer. In this study, we evaluate the possibility of D-dimer as a predictor of 30-day mortality in stroke patients with active cancer. Methods: We included 210 ischemic stroke patients with active cancer. The data of 30-day mortality were collected by reviewing medical records. We also collected follow-up D-dimer levels in 106 (50%) participants to evaluate the effects of treatment response on D-dimer levels. Results: Of the 210 participants, 30-day mortality occurred in 28 (13%) patients. Higher initial NIHSS score, D-dimer levels, CRP levels, frequent cryptogenic mechanism, systemic metastasis, multiple vascular territory lesion, hemorrhagic transformation, and larger infarct volume were related to 30-day mortality. In the multivariate analysis, D-dimer [adjusted OR (aOR) = 2.19; 95% CI, 1.46-3.28, P < 0.001] predicted 30-day mortality after adjusting for confounders. Initial NIHSS score (aOR = 1.07; 95% CI, 1.00-1.14, P = 0.043) and hemorrhagic transformation (aOR = 3.02; 95% CI, 1.10-8.29, P = 0.032) were also significant independently from D-dimer levels. In the analysis of D-dimer changes after treatment, the mortality group showed no significant decrease of D-dimer levels, despite treatment, while the survivor group showed opposite responses. Conclusions: D-dimer levels may predict 30-day mortality in acute ischemic stroke patients with active cancer.

scholarly journals Faktor Faktor Risiko terjadinya Pneumonia pada Stroke Akut di RSUP Dr Hasan Sadikin Bandung

2021 ◽  
Vol 10 (3) ◽  
pp. 151-161
Author(s):  
Novi Fatni Muhafidzah ◽  
◽  
Sobaryati Mansur ◽  
Emmy Hermiyanti Pranggono ◽  
Yusuf Wibisono ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infarct Size ◽  
Acute Stroke ◽  
Primary Data ◽  
Neurogenic Pulmonary Edema ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Stroke Treatment ◽  
Large Infarct

Risk Factors of Pneumonia in Acute Stroke at Hasan Sadikin Hospital Bandung Abstract Background and Objective:Pneumonia is the most common non neurological complications in acute stroke (22%) that increase mortality rate, length of stay and hospitalization cost. It is necessary to identified risk factors for pneumonia including neurogenic pulmonary edema (NPE) for better prevention and early intervention. The purpose of this study is to determine risk factors of pneumonia (including NPE) in acute stroke patients at Hasan Sadikin General Hospital Bandung. Subject and Methods: Prospective observational descriptive study, consecutive sampling method, during September – October 2019. Primary data collected from acute stroke patients such as stroke severity, type, location and size of stroke, treatment during hospitalizataion, comorbidities (including NPE). Pneumonia was diagnosed based on Central for Disease Control Prevention (CDC) criteria, NPE based on Davison criteria. Results: 30 patients (28.3%) with pneumonia in acute stroke patients. Pneumonia were commonly found in NGT insertion (90%), dysphagia (64,71%), total anterior circulation infarct (TACI) (61,54%), large infarct size (61,54%), GCS 9-12 (50%) and NIHSS 16-20 (50%). NPE only found in 6,60% acute stroke patients, 57,14% of them developed pneumonia. Conclusions: Pneumonia in acute stroke patients is more often found in NGT insertion, dysphagia, TACI location, large infarct size, lower GCS and more severe stroke degree.

Abstract 127: Predictors of Good Functional Outcomes in an Acute Ischemic Stroke Cohort with a Large Infarct Core Treated with Mechanical Thrombectomy: Signals to Treat?

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jeffrey Wagner ◽  
Donald Frei ◽  
Raul Nogueira ◽  
Adnan Siddiqui ◽  
Osama O Zaidat ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Mechanical Thrombectomy ◽  
Infarct Volume ◽  
Target Vessel ◽  
Infarct Core ◽  
Nihss Score ◽  
Good Outcome ◽  
Large Infarct

Purpose: Mechanical thrombectomy has been demonstrated to provide benefits in the treatment of acute ischemic stroke (AIS). But whether to treat AIS patients with a large infarct core remains controversial. Although it is a common practice that patients with large infarct core are not offered endovascular treatment, previous data have consistently shown a proportion of these patients may benefit from IA intervention. The purpose of this study is to identify predictors of good outcomes in an AIS cohort with a large infarct volume previously treated with mechanical thrombectomy. Hypothesis: We hypothesize that among AIS patients with a large infarct volume, younger patients (≤66 years) who present with lower NIHSS scores will show good functional outcomes (mRS 0-2) at 90 days if treated with mechanical thrombectomy. Methods: Univariable and multivariable analyses were preformed to identify factors that predict good functional outcomes in AIS patients with ASPECTS 0-5 who were treated with the Penumbra System. Five previous prospective, multicenter trials (PIVOTAL, PICS, RetroSTART, START, SEPARATOR 3D) were included in this study. Patients who presented with symptoms of AIS were analyzed for association between presenting demographics and modified Rankin scale (mRS) score at 90 days in univariate and multivariate analyses. Results: Data for 614 patients with a median age of 69 years and an NIHSS score of 18 met study criteria. Of these, the 90-day mRS 0-2 rate and mortality were, respectively, 40.23% and 25.41%. Among those with ASPECTS 0-5 (N=93), 17.20% had good functional outcome. An age of ≤66 years was significantly associated with good outcome (p<0.0001) among those with ASPECTS 0-5. Within this age group who had ASPECTS 0-5, a baseline NIHSS score of ≤ 20 (p= 0.0088) with a target vessel location at the MCA (p=0.0210) were also strong predictors of good outcome if treated by mechanical thrombectomy. Conclusion: These data demonstrate that age ≤66 years, baseline NIHSS score of ≤ 20 with a target vessel location in the MCA are important predictors of good outcomes in an AIS cohort with a large infarct core who are eligible for mechanical thrombectomy.

scholarly journals Neurobiochemical Markers of Brain Damage in Cerebrospinal Fluid of Acute Ischemic Stroke Patients

2010 ◽  
Vol 56 (3) ◽  
pp. 451-458 ◽  
Author(s):  
Raf Brouns ◽  
Bart De Vil ◽  
Patrick Cras ◽  
Didier De Surgeloose ◽  
Peter Mariën ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Calcium Binding ◽  
Infarct Volume ◽  
Neuron Specific Enolase ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Nihss Score

Abstract Background: Ischemic injury to the central nervous system causes cellular activation and disintegration, leading to release of cell-type–specific proteins into the cerebrospinal fluid (CSF). We investigated CSF concentrations of myelin basic protein (MBP), glial fibrillary astrocytic protein (GFAP), the calcium-binding protein S100B, and neuron-specific enolase (NSE) in acute ischemic stroke patients and their relation to initial stroke severity, stroke location, and long-term stroke outcome. Methods: CSF concentrations of MBP, GFAP, S100B, and NSE were assessed in 89 stroke patients on admission (mean 8.7 h after stroke onset) and in 35 controls. We evaluated the relation between CSF concentrations and (a) stroke severity (NIH Stroke Scale [NIHSS] score on admission, infarct volume), (b) stroke location, and (c) stroke outcome (modified Rankin Scale [mRS] score at month 3). Results: MBP concentration was significantly higher in subcortical than in cortical infarcts (median MBP, 1.18 vs 0.66 μg/L, P &lt; 0.001). GFAP and S100B concentrations correlated with the NIHSS score on admission (GFAP, R = 0.35, P = 0.001; S100B, R = 0.29, P = 0.006), infarct volume (GFAP, R = 0.34, P = 0.001; S100B, R = 0.28, P = 0.008), and mRS score at month 3 (R = 0.42, P &lt; 0.001 and R = 0.28, P = 0.007). Concentrations of NSE did not correlate with stroke characteristics. Conclusions: MBP, GFAP, S100B, and NSE display relevant differences in cellular and subcellular origins, which are reflected in their relation to stroke characteristics. MBP is a marker for infarct location. GFAP and S100B correlate with stroke severity and outcome.

scholarly journals Automated CT Perfusion for Ischemic Core Volume Prediction in Tandem Anterior Circulation Occlusions

2016 ◽  
Vol 5 (1-2) ◽  
pp. 81-88 ◽  
Author(s):  
Diogo C. Haussen ◽  
Seena Dehkharghani ◽  
Mikayel Grigoryan ◽  
Meredith Bowen ◽  
Leticia C. Rebello ◽  
...  
Keyword(s):  
Ct Perfusion ◽  
Infarct Volume ◽  
Volume Estimation ◽  
Large Vessel ◽  
Absolute Difference ◽  
Analysis Tool ◽  
Anterior Circulation ◽  
Ischemic Core ◽  
The Impact ◽  
Core Volume

Background/Aim: CT perfusion (CTP) predicts ischemic core volumes in acute ischemic stroke (AIS); however, assumptions made within the pharmacokinetic model may engender errors by the presence of tracer delay or dispersion. We aimed to evaluate the impact of hemodynamic disturbance due to extracranial anterior circulation occlusions upon the accuracy of ischemic core volume estimation with an automated perfusion analysis tool (RAPID) among AIS patients with large-vessel occlusions. Methods: A prospectively collected, interventional database was retrospectively reviewed for all cases of endovascular treatment of AIS between September 2010 and March 2015 for patients with anterior circulation occlusions with baseline CTP and full reperfusion (mTICI3). Results: Out of 685 treated patients, 114 fit the inclusion criteria. Comparison between tandem (n = 21) and nontandem groups (n = 93) revealed similar baseline ischemic core (20 ± 19 vs. 19 ± 25 cm3; p = 0.8), Tmax >6 s (175 ± 109 vs. 162 ± 118 cm3; p = 0.6), Tmax >10 s (90 ± 84 vs. 90 ± 91 cm3; p = 0.9), and final infarct volumes (45 ± 47 vs. 37 ± 45 cm3; p = 0.5). Baseline core volumes were found to correlate with final infarct volumes for the tandem (r = 0.49; p = 0.02) and nontandem (r = 0.44; p < 0.01) groups. The mean absolute difference between estimated core and final infarct volume was similar between patients with and those without (24 ± 41 vs. 17 ± 41 cm3; p = 0.5) tandem lesions. Conclusions: The prediction of baseline ischemic core volumes through an optimized CTP analysis employing rigorous normalization, thresholding, and voxel-wise analysis is not significantly influenced by the presence of underlying extracranial carotid steno-occlusive disease in large-vessel AIS.

scholarly journals NILAI DIAGNOSTIK SKOR STROKE DAVE UNHAS PADA PENDERITA STROKE ISKEMIK KARDIOEMBOLI DENGAN FIBRILASI ATRIUM

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Supardin Supardin ◽  
David Gunawan ◽  
Cahyono Kaelan
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Ct Scan ◽  
Predictive Value ◽  
Area Under Curve ◽  
Diagnostic Value ◽  
Receiver Operating Characteristics ◽  
P Value ◽  
Operating Characteristics ◽  
Stroke Patients

  DIAGNOSTIC VALUE OF DAVE UNHAS STROKE SCORE IN CARDIOEMBOLIC ISCHEMIC STROKE PATIENTS WITH ATRIAL FIBRILLATIONABSTRACTIntroduction: It is important to diagnose cardioembolic ischemic stroke quickly especially in the absence of CT scan/MRI, besides having a poor prognosis, cardioembolic ischemic stroke also has high disability and death rates.Aim: To investigate the diagnostic value of Dave Unhas Stroke Score (DUSS) in cardioembolic ischemic stroke patients with atrial fibrillation (AF).Methods: This was a diagnostic test research on cardioembolic ischemic stroke sufferers with AF and without cardioemboli in Wahidin Sudirohusodo Hospital and its networking hospital in Makassar from September 2018 to March 2019. DUSS consists of 5 variables: blood pressure (BP), activity at onset, headache, vomiting, and level of consciousness were assessed in both groups. DUSS cut off point was determined by receiver operating characteristics (ROC). The test results are considered as statistically significant if the p value <0.05.Results: There were 80 subjects consisting of 40 subjects each in the cardioembolic and noncardioembolic ischemic stroke groups. The research results showed diagnostic value of DUSS in cardioembolic ischemic stroke patients due to atrial  fibrillation with cut off point 10 had a sensitivity of 95.0%, specificity 97.5%, positive predictive value 97.4%, negative predictive value 95.1%, and accuracy 96.2%. The results of this calculation shown area under curve (AUC) on the ROC curve that is 99.6% with a very significant p value (p <0.001) which means DUSS can be used to distinguish between cardioembolic ischemic stroke due to AF (score >10) from noncardioembolic ischemic stroke (score <10).Discussion: DUSS 10 cut off point can distinguish cardioembolic ischemic stroke due to AF and noncardioembolic.Keywords:  Dave Unhas  Stroke  Score, cardioembolic ischemic stroke patients with atrial fibrillation, noncardioembolic ischemic stroke, diagnostic value, cut-off pointABSTRAKPendahuluan: Mendiagnosis stroke iskemik kardioemboli dengan cepat penting dilakukan terutama pada keadaan tidak tersedianya CT scan/MRI, selain karena memiliki prognosis yang buruk, juga memiliki angka kecacatan dan kematian yang tinggi.Tujuan: Mengetahui nilai diagnostik Skor Stroke Dave Unhas (SSDU) pada penderita stroke iskemik kardioemboli akibat fibrilasi atrium (FA).Metode: Penelitian uji diagnostik terhadap penderita stroke iskemik kardioemboli dengan FA dan nonkardioemboli di RS Wahidin Sudirohusodo dan jejaringnya di Makassar pada bulan September 2018-Maret 2019. Dilakukan penghitungan SSDU berdasarkan 5 variabel: tekanan darah (TD), aktivitas saat serangan, nyeri kepala, muntah, dan tingkat kesadaran pada kedua kelompok serta cut off point SSDU yang optimal menggunakan receiver operating characteristics (ROC). Hasil uji statistik signifikan jika nilai p<0,05.Hasil: Didapatkan 80 subjek yang terdiri dari masing-masing 40 subjek pada kelompok stroke iskemik kardioemboli dan nonkardioemboli. Hasil penelitian menunjukkan nilai diagnostik SSDU pada penderita stroke iskemik kardioemboli akibat FA dengan cut off point 10 memiliki sensitivitas 95,0%, spesifisitas 97,5%, nilai prediksi positif 97,4%, nilai prediksi negatif 95,1%, dan akurasi 96,2%.  Hasil perhitungan ini menunjukkan area under curve (AUC) pada kurva ROC, yaitu 99,6% dengan nilai p yang sangat signifikan (p<0,001) yang berarti SSDU dapat digunakan untuk membedakan antara SIkardioemboli akibat FA (skor >10) dengan stroke iskemik nonkardioemboli (skor <10).Diskusi: Diperoleh cut off point SSDU 10 yang dapat membedakan stroke iskemik kardioemboli akibat FA dan nonkardioemboli.Kata kunci: Fibrilasi atrium, kardioemboli, nonkardioemboli, nilai diagnostik, stroke iskemik, Skor Stroke Dave Unhas  

Endovascular Therapy for Large Vessel Stroke in the Elderly: Hope in the New Stroke Era

2016 ◽  
Vol 42 (5-6) ◽  
pp. 421-427 ◽  
Author(s):  
Andrey Lima ◽  
Diogo C. Haussen ◽  
Leticia C. Rebello ◽  
Seena Dehkharghani ◽  
Jonathan Grossberg ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Ct Perfusion ◽  
Infarct Volume ◽  
The Elderly ◽  
Outcome Data ◽  
Large Vessel ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Nihss Score ◽  
Good Outcome

Background and Purpose: Acute ischemic stroke (AIS) in the elderly encompasses approximately one-third of all AIS cases. Outcome data have been for the most part discouraging in this population. We aim to evaluate the outcomes in a large contemporary series of elderly patients treated with thrombectomy. Methods: Retrospective analysis of a single-center endovascular database for consecutive elderly (≥80 years) patients treated for anterior circulation large vessel occlusion AIS between September 2010 and April 2015. Univariate- and multivariate analyses were performed to identify the predictors of good clinical outcome (90-day modified Ranking Scale [mRS] ≤2). Receiver operating characteristic curves were used to calculate the optimal final infarct volume (FIV) threshold to predict good outcomes. Results: A total of 111 patients met our inclusion criteria (mean age 84.8 ± 4.2 years; National Institutes of Health Stroke Scale [NIHSS] score 19.1 ± 5.6; time from last-known normal to puncture, 349.6 ± 246.6 min; 33% male; 68% Alberta Stroke Program Early CT Score [ASPECTS] ≥8). The rates of successful reperfusion (modified treatment in cerebral ischemia ≥2b), symptomatic intracranial hemorrhage and 90-day mortality were 80%, 7% and 41%, respectively. The overall rate of good outcome was 29% (n = 32/111) but was 52% (n = 13/25) in patients with baseline mRS score of 0-2 who were selected based on CT perfusion and treated with stent retrievers. On multivariate analysis, only ASPECTS (OR 2.17; 95% CI 1.28-3.67.7; p = 0.004) and baseline NIHSS score (OR 0.87; 95% CI 0.77-0.97; p = 0.013) were independently associated with good outcome. A FIV ≤16 ml demonstrated the greatest accuracy for identifying good outcomes (sensitivity 75.0%, specificity 82.6%). Conclusions: Our results are encouraging demonstrating nearly one-third of elderly patients achieving full independence at 90 days. Contemporary treatment paradigms employing optimized patient selection and modern thrombectomy technology may result in even better outcomes.

Abstract T P44: Grade of Cortical Vessel Signs on Susceptibility-weighted Imaging Predicts Outcomes in Acute Stroke Patients

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Teppei Komatsu ◽  
Kenichi Sakuta ◽  
Takashi Shimoyama ◽  
Yuka Terasawa ◽  
Hidetaka Mitsumura ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Unfavorable Outcome ◽  
Clinical Implications ◽  
Susceptibility Weighted Imaging ◽  
Signal Loss ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Nihss Score ◽  
Proportional Rate ◽  
Cortical Vessel

Introduction: Cortical vessel signs (CVSs) on susceptibility-weighted MR imaging (SWI) are frequently observed in acute ischemic stroke patients. However, the clinical implications of this sign have not yet been clearly defined. We assumed the hypothesis that grade of CVSs on SWI predicts outcomes in acute stroke patients. Methods: We retrospectively enrolled stroke patients who presented with anterior circulation cerebral infarction within 24 hours after onset. We excluded patients with no SWI. CVSs was defined as more veins or lager veins with a greater signal loss on SWI than those in the opposite normal hemisphere. CVSs was graded as 1) absent, 2) subtle as presence of CVSs less than 1/3 of the anterior circulation perfusion lesion, or 3) prominent as presence of CVSs more than 1/3 of the perfusion lesion. Unfavorable outcome was defined as discharge modified Rankin scale score 4-6. Results: We included 114 patients from October 2012 to June 2014, 71% of patients were men, median age was 71 years, and the average initial NIHSS score was 7 (range 0-32). CVSs was seen in 53 (47%) of patients. There were 14 patients (13%) with subtle CVSs, and 39 patients (35%) with prominent CVSs. Unfavorable outcome was as follows: 15% of patients with none CVSs, 43% with subtle CVSs, and 59% with prominent CVSs (figure 1). As with grade of CVSs, proportional rate of unfavorable patients gradually increased (P < 0.01). Conclusions: Grade of CVSs on SWI can predict outcomes in acute stroke patients.

scholarly journals Pertinence of score for neonatal acute physiology-II to prognosticate mortality and organ dysfunction in neonatal sepsis

2020 ◽  
Vol 71 ◽  
pp. 60-65
Author(s):  
A. A. Verma ◽  
U. C. Rajput ◽  
A. A. Kinikar
Keyword(s):  
Organ Dysfunction ◽  
Predictive Value ◽  
Area Under Curve ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Mortality And Morbidity ◽  
Mortality Outcome ◽  
Operating Characteristic Curve ◽  
Sensitivity Specificity ◽  
Prospective Investigation

Introduction: The present investigation was undertaken to correlation between mortality and morbidity (organ dysfunction [OD]) and score for neonatal acute physiology-II (SNAP-II). Materials and Methods: A prospective investigation of newborns neonates, a total 157 neonates 82 male (52.2%), female 75 (47.8%) were enrolled and disunited into four groups according to gestational age: 28 to 30 weeks (G1), 31 to 33 (G2) 34 to 36 weeks (G3) and >37 weeks (G4) variables analyzed were SNAP II. Results and Discussion: The receiver operating characteristic curve for SNAP-II score and death is more predictive in correlation to OD (area under curve of death is 0.776 as compared to 0.553 for OD). The sensitivity, specificity, positive predictive value, and negative predictive value of SNAP-II score with mortality (outcome) were 42.8%, 100%, 100%, and 82.3%, respectively. Conclusion: The SNAP-II revealed efficient to fantabulous ≥40 can prognosticate OD and death when applied on admission to neonates with sepsis.

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