Is mRankin scale correlated with mTICI? A systematic review and meta-regression on RCTs and registries

Abstract

AbstractBackground and PurposemTICI ≥2b/3 is one of the strongest positive predictors of mRS ≤2. Quantitative analysis is poorly investigated. Reconcile results from RCT and registries is still a challenge.The purpose was to evaluate the numeric correlation between mTICI≥2b/3 and mRS≤2 in RCT and registries.MethodsLiterature research was performed on Pubmed for studies in 2015-2020. mTICI, mRS and sample size were recorded. Exclusion criteria were monocentric study, not-human and not-English. Studies quality were assessed with MINORS and RoB2. Meta-logistic and meta-linear regressions were used to correlate mTICI and mRS in both RCTs and registries. Z-test was used for comparing coefficients between RCTs and registries.ResultsTwenty-six studies were evaluated (13 registries; 14 RCTs) for 24423 patients (21914 from registries [average per registry 1685±1277]; 2509 from RCTs [average per RCT 179±160]). RCTs involved anterior circulation only, 7/13 (53.8%) registries considered also posterior one.The OR of obtaining a mRS≤2 for a singular increased of mTICI ≥2b rate was 1.65 (CI95% 1.22-2.01) for all studies, 1.65 (CI95% 1.10-2.46) for RCTs and 1.50 (CI95% 1.00-2.23) for registries. mTICI≥2b and mRS had a positive correlation with a coefficient of 0.49 (CI95% 0.19-0.80, p=0.001) for all studies, 0.54 (CI95% 0.09-1.00) for RCTs and 0.42 (CI 95% 0.04-0.81) for registries. No differences were found in the coefficients between RCTs and registries (p=0.63; p=0.65; respectively).ConclusionsUnitary increased of mTICI≥2b rate correspond to an augment of mRS≤2 by 0.50 (CI95% 0.19-0.89) with OR of obtaining mRS≤2 of 1.65 (CI95% 1.22-2.01), without significantly differences in coefficients.