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Early clinical surrogates for outcome prediction after stroke thrombectomy in daily clinical practice

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Early clinical surrogates for outcome prediction after stroke thrombectomy in daily clinical practice. / Meyer, Lukas; Broocks, Gabriel; Bechstein, Matthias; Flottmann, Fabian; Leischner, Hannes; Brekenfeld, Caspar; Schön, Gerhard; Deb-Chatterji, Milani; Alegiani, Anna; Thomalla, Götz; Fiehler, Jens; Kniep, Helge; Hanning, Uta; German Stroke Registry – Endovascular Treatment (GSR – ET).

in: J NEUROL NEUROSUR PS, Jahrgang 91, Nr. 10, 10.2020, S. 1055-1059.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Meyer, L, Broocks, G, Bechstein, M, Flottmann, F, Leischner, H, Brekenfeld, C, Schön, G, Deb-Chatterji, M, Alegiani, A, Thomalla, G, Fiehler, J, Kniep, H, Hanning, U & German Stroke Registry – Endovascular Treatment (GSR – ET) 2020, 'Early clinical surrogates for outcome prediction after stroke thrombectomy in daily clinical practice', J NEUROL NEUROSUR PS, Jg. 91, Nr. 10, S. 1055-1059. https://doi.org/10.1136/jnnp-2020-323742

APA

Meyer, L., Broocks, G., Bechstein, M., Flottmann, F., Leischner, H., Brekenfeld, C., Schön, G., Deb-Chatterji, M., Alegiani, A., Thomalla, G., Fiehler, J., Kniep, H., Hanning, U., & German Stroke Registry – Endovascular Treatment (GSR – ET) (2020). Early clinical surrogates for outcome prediction after stroke thrombectomy in daily clinical practice. J NEUROL NEUROSUR PS, 91(10), 1055-1059. https://doi.org/10.1136/jnnp-2020-323742

Vancouver

Meyer L, Broocks G, Bechstein M, Flottmann F, Leischner H, Brekenfeld C et al. Early clinical surrogates for outcome prediction after stroke thrombectomy in daily clinical practice. J NEUROL NEUROSUR PS. 2020 Okt;91(10):1055-1059. https://doi.org/10.1136/jnnp-2020-323742

Bibtex

@article{be8bd804ed0a4e93885e7f50392cf29b,
title = "Early clinical surrogates for outcome prediction after stroke thrombectomy in daily clinical practice",
abstract = "BACKGROUND AND PURPOSE: To investigate early clinical surrogates for long-term independency of patients treated with thrombectomy for large vessel occlusion stroke in daily clinical routine.METHODS: All patients with anterior circulation stroke enrolled in the German Stroke Registry-Endovascular Treatment from 07/2015 to 04/2018 were analysed. National Institute of Health Stroke Scale (NIHSS) on admission, NIHSS percentage change, NIHSS delta and NIHSS at 24 hours as well as existing binary definitions of early neurological improvement (ENI; improvement of 8 (major ENI)/10 (dramatic ENI) NIHSS points or reaching 0/1 were compared for predicting functional outcome at 90 days using the modified Rankin Scale (mRS). Excellent and favourable outcome were defined as 0-1 and 0-2, respectively.RESULTS: Among 2262 endovasculary treated patients with acute ischaemic anterior circulation stroke, NIHSS at 24 hours had the highest discriminative ability to predict excellent (receiver operator characteristics (ROC)NIHSS 24 hours area under the curve (AUC) 0.86 (0.84-0.88)) and favourable long-term functional outcome (ROCNIHSS 24 hours AUC 0.86 (0.85-0.88)) in comparison to NIHSS percentage change (ROC% change AUC mRS ≤1: 0.81 (0.78-0.83) mRS ≤2: 0.81 (0.79-0.83)), NIHSS delta change (ROCΔ change AUC mRS ≤1: 0.74 (0.72-0.77), mRS ≤2: 0.77 (0.74-0.79)) and NIHSS admission (ROCAdm AUC mRS ≤1: 0.70 (0.68-0.73), mRS ≤2: 0.67 (0.68-0.71)). Advanced age was the only independent predictor (adjusted OR 1.05, 95% CI 1.03 to 1.07, p<0.001) for turning the outcome prognosis from favourable (mRS ≤2) to poor (mRS ≥4) at 90 days.CONCLUSION: The NIHSS at 24 hours postintervention with a threshold of ≤8 points serves best as a surrogate for long-term functional outcome after thrombectomy for anterior circulation stroke in daily clinical practice. Only advanced age significantly decreases its predictive value.",
author = "Lukas Meyer and Gabriel Broocks and Matthias Bechstein and Fabian Flottmann and Hannes Leischner and Caspar Brekenfeld and Gerhard Sch{\"o}n and Milani Deb-Chatterji and Anna Alegiani and G{\"o}tz Thomalla and Jens Fiehler and Helge Kniep and Uta Hanning and {German Stroke Registry – Endovascular Treatment (GSR – ET)}",
note = "{\textcopyright} Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2020",
month = oct,
doi = "10.1136/jnnp-2020-323742",
language = "English",
volume = "91",
pages = "1055--1059",
journal = "J NEUROL NEUROSUR PS",
issn = "0022-3050",
publisher = "BMJ PUBLISHING GROUP",
number = "10",

}

RIS

TY - JOUR

T1 - Early clinical surrogates for outcome prediction after stroke thrombectomy in daily clinical practice

AU - Meyer, Lukas

AU - Broocks, Gabriel

AU - Bechstein, Matthias

AU - Flottmann, Fabian

AU - Leischner, Hannes

AU - Brekenfeld, Caspar

AU - Schön, Gerhard

AU - Deb-Chatterji, Milani

AU - Alegiani, Anna

AU - Thomalla, Götz

AU - Fiehler, Jens

AU - Kniep, Helge

AU - Hanning, Uta

AU - German Stroke Registry – Endovascular Treatment (GSR – ET)

N1 - © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/10

Y1 - 2020/10

N2 - BACKGROUND AND PURPOSE: To investigate early clinical surrogates for long-term independency of patients treated with thrombectomy for large vessel occlusion stroke in daily clinical routine.METHODS: All patients with anterior circulation stroke enrolled in the German Stroke Registry-Endovascular Treatment from 07/2015 to 04/2018 were analysed. National Institute of Health Stroke Scale (NIHSS) on admission, NIHSS percentage change, NIHSS delta and NIHSS at 24 hours as well as existing binary definitions of early neurological improvement (ENI; improvement of 8 (major ENI)/10 (dramatic ENI) NIHSS points or reaching 0/1 were compared for predicting functional outcome at 90 days using the modified Rankin Scale (mRS). Excellent and favourable outcome were defined as 0-1 and 0-2, respectively.RESULTS: Among 2262 endovasculary treated patients with acute ischaemic anterior circulation stroke, NIHSS at 24 hours had the highest discriminative ability to predict excellent (receiver operator characteristics (ROC)NIHSS 24 hours area under the curve (AUC) 0.86 (0.84-0.88)) and favourable long-term functional outcome (ROCNIHSS 24 hours AUC 0.86 (0.85-0.88)) in comparison to NIHSS percentage change (ROC% change AUC mRS ≤1: 0.81 (0.78-0.83) mRS ≤2: 0.81 (0.79-0.83)), NIHSS delta change (ROCΔ change AUC mRS ≤1: 0.74 (0.72-0.77), mRS ≤2: 0.77 (0.74-0.79)) and NIHSS admission (ROCAdm AUC mRS ≤1: 0.70 (0.68-0.73), mRS ≤2: 0.67 (0.68-0.71)). Advanced age was the only independent predictor (adjusted OR 1.05, 95% CI 1.03 to 1.07, p<0.001) for turning the outcome prognosis from favourable (mRS ≤2) to poor (mRS ≥4) at 90 days.CONCLUSION: The NIHSS at 24 hours postintervention with a threshold of ≤8 points serves best as a surrogate for long-term functional outcome after thrombectomy for anterior circulation stroke in daily clinical practice. Only advanced age significantly decreases its predictive value.

AB - BACKGROUND AND PURPOSE: To investigate early clinical surrogates for long-term independency of patients treated with thrombectomy for large vessel occlusion stroke in daily clinical routine.METHODS: All patients with anterior circulation stroke enrolled in the German Stroke Registry-Endovascular Treatment from 07/2015 to 04/2018 were analysed. National Institute of Health Stroke Scale (NIHSS) on admission, NIHSS percentage change, NIHSS delta and NIHSS at 24 hours as well as existing binary definitions of early neurological improvement (ENI; improvement of 8 (major ENI)/10 (dramatic ENI) NIHSS points or reaching 0/1 were compared for predicting functional outcome at 90 days using the modified Rankin Scale (mRS). Excellent and favourable outcome were defined as 0-1 and 0-2, respectively.RESULTS: Among 2262 endovasculary treated patients with acute ischaemic anterior circulation stroke, NIHSS at 24 hours had the highest discriminative ability to predict excellent (receiver operator characteristics (ROC)NIHSS 24 hours area under the curve (AUC) 0.86 (0.84-0.88)) and favourable long-term functional outcome (ROCNIHSS 24 hours AUC 0.86 (0.85-0.88)) in comparison to NIHSS percentage change (ROC% change AUC mRS ≤1: 0.81 (0.78-0.83) mRS ≤2: 0.81 (0.79-0.83)), NIHSS delta change (ROCΔ change AUC mRS ≤1: 0.74 (0.72-0.77), mRS ≤2: 0.77 (0.74-0.79)) and NIHSS admission (ROCAdm AUC mRS ≤1: 0.70 (0.68-0.73), mRS ≤2: 0.67 (0.68-0.71)). Advanced age was the only independent predictor (adjusted OR 1.05, 95% CI 1.03 to 1.07, p<0.001) for turning the outcome prognosis from favourable (mRS ≤2) to poor (mRS ≥4) at 90 days.CONCLUSION: The NIHSS at 24 hours postintervention with a threshold of ≤8 points serves best as a surrogate for long-term functional outcome after thrombectomy for anterior circulation stroke in daily clinical practice. Only advanced age significantly decreases its predictive value.

U2 - 10.1136/jnnp-2020-323742

DO - 10.1136/jnnp-2020-323742

M3 - SCORING: Journal article

C2 - 32934109

VL - 91

SP - 1055

EP - 1059

JO - J NEUROL NEUROSUR PS

JF - J NEUROL NEUROSUR PS

SN - 0022-3050

IS - 10

ER -