Outcome Prediction in Acute Stroke Patients Considered for Endovascular Treatment: A Novel Tool

Abstract

Functional outcome following emergent intra-arterial thrombectomy is variable and likely reflects the heterogeneous characteristics of acute stroke patients. The aims of our study were (1) to study which pre-treatment variables correlate with functional outcome and (2) to devise a tool which would reliably predict outcome. Prospective data of patients treated with intra-arterial mechanical thrombectomy in our institution between 2010 and 2012 were collected. A preliminary univariate analysis of baseline variables was performed and data outliers were identified by constructing scatter and box plots. Systematic bivariate analysis was then carried out using a linear regression model and the individual contributing weights of the variables to outcome calculated. The B and constant values from the regression were used to construct a predictive formula. Fifty-seven patients, 35 males (61.4%) and 22 females (38.6%) with a mean age of 62.3 years (range 26–87) were included in the cohort. Statistical correlations of baseline variables and functional outcome showed that age, National Institutes of Health Stroke Scale at presentation and CT leptomeningeal collaterals were strongly correlated (p<0.01), and were later included in the linear regression model. A tool was devised from the regression formula combining weighted inputs of the three variables. Regression statistics and residual analysis were then performed to assess the accuracy and reliability of the proposed tool. The proposed tool is easy to use and reliably predicts functional outcome prior to endovascular therapy. It may help clinical decision-making in the acute setting and offers ‘tailor-made’ outcome expectations.