| Extent of Hypoattenuation on CT Angiography Source Images in Basilar Artery Occlusion: Prognostic Value in the Basilar Artery International Cooperation Study. | |
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MedLine Citation:
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PMID: 21960577 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) quantifies the extent of early ischemic changes in the posterior circulation with a 10-point grading system. We hypothesized that pc-ASPECTS applied to CT angiography source images predicts functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). METHODS: BASICS was a prospective, observational registry of consecutive patients with acute symptomatic basilar artery occlusion. Functional outcome was assessed at 1 month. We applied pc-ASPECTS to CT angiography source images of patients with CT angiography for confirmation of basilar artery occlusion. We calculated unadjusted and adjusted risk ratios (RRs) of pc-ASPECTS dichotomized at ≥8 versus <8. Primary outcome measure was favorable outcome (modified Rankin Scale scores 0-3). Secondary outcome measures were mortality and functional independence (modified Rankin Scale scores 0-2). RESULTS: Of 158 patients included, 78 patients had a CT angiography source images pc-ASPECTS ≥8. Patients with a pc-ASPECTS ≥8 more often had a favorable outcome than patients with a pc-ASPECTS <8 (crude RR, 1.7; 95% CI, 0.98-3.0). After adjustment for age, baseline National Institutes of Health Stroke Scale score, and thrombolysis, pc-ASPECTS ≥8 was not related to favorable outcome (RR, 1.3; 95% CI, 0.8-2.2), but it was related to reduced mortality (RR, 0.7; 95% CI, 0.5-0.98) and functional independence (RR, 2.0; 95% CI, 1.1-3.8). In post hoc analysis, pc-ASPECTS dichotomized at ≥6 versus <6 predicted a favorable outcome (adjusted RR, 3.1; 95% CI, 1.2-7.5). CONCLUSIONS: pc-ASPECTS on CT angiography source images independently predicted death and functional independence at 1 month in the CT angiography subgroup of patients in the BASICS registry. |
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Authors:
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Volker Puetz; Andrei Khomenko; Michael D Hill; Imanuel Dzialowski; Patrik Michel; Christian Weimar; Christine A C Wijman; Heinrich P Mattle; Stefan T Engelter; Keith W Muir; Thomas Pfefferkorn; David Tanne; Kristina Szabo; L Jaap Kappelle; Ale Algra; Ruediger von Kummer; Andrew M Demchuk; Wouter J Schonewille; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-29 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: - ISSN: 1524-4628 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From St Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands; the Utrecht Stroke Center, Utrecht, The Netherlands; the Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands; the University of Bern, Bern, Switzerland; University Hospital Basel, Basel, Switzerland; Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland; Dresden University Stroke Center, Dresden, Germany; the University of Duisburg-Essen, Essen, Germany; the University of Leipzig, Leipzig, Germany; Medizinische Hochschule Hannover, Hannover, Germany; University Clinics Freiburg, Freiburg, Germany; the University of Munich, Klinikum Grosshadern, Munich, Germany; Universitätsklinikum Mannheim, Mannheim, Germany; Stanford University, Stanford, CA; Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada; the Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; the University of Glasgow, Glasgow, UK; and Sheba Medical Center and Tel Aviv University, Tel Aviv, Israel. |
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