Abstract 144: The Pittsburgh Outcomes After Stroke Thrombectomy (POST) Score Predicts Good Outcomes After Endovascular Therapy for Anterior Circulation Large Vessel Occlusions
Background: Independent predictors of good outcome following large vessel occlusions (LVO) include age, infarct volume, NIHSS at presentation and revascularization status. The aim of this study was to develop an easy-to-use tool to predict good outcome following endovascular treatment for LVO.
Methods: In a derivation cohort of patients with anterior circulation LVO treated with endovascular therapy at Grady Memorial Hospital (GMH, n=247), we performed logistic regression to identify independent predictors of good outcome (mRS 0-2 at 90 days). Factors were weighted based on B-coefficients to generate a score (POST) that predicts good outcome. The derivation cohort was divided in risk group quartiles and correlation analysis between predicted and observed rates of good outcomes was performed. POST was also validated in two cohorts derived from the University of Pittsburgh Medical Center (UPMC, n=380) and the DEFUSE 2 database (n=105).
Results: In the derivation cohort (mean age 66±1 yrs, median NIHSS 18), independent predictors (p<0.2) of good outcome included final infarct volume (FIV; OR 0.97, 0.96-0.98), age (OR 0.96, 0.94-0.98), NIHSS at presentation (OR 0.93, 0.88-0.98) and PH1/PH2 hemorrhage (H; OR 0.3, 0.06-1.6, p=0.15). POST was defined as Age + 0.5 X FIV + 15 X H. Patients in the lowest POST quartile (<60) had a 91% chance of good outcome as compared to 3% in the highest POST quartile (≥120). There was a strong correlation between predicted and observed rates of good outcomes in the 4 groups (R=0.99, p<.001). POST performed well in predicting good outcomes in the derivation (AUC=0.85), as well as the UPMC (AUC=0.81) and DEFUSE 2 (AUC=0.86) validation cohorts.
Discussion: The POST score is a validated tool to predict good clinical outcomes following endovascular therapy in patients with acute large vessel occlusions. This tool can guide families and physicians in clinical decision making following endovascular therapy.
Author Disclosures: S. Rangaraju: None. J.T.P. Liggins: None. A. Aghaebrahim: None. C. Streib: None. C. Sun: None. R. Gupta: Other; Modest; Consultant: Stryker Neurovascular, Covidien, Rapid Medical Royalties: UpToDate Associate editor of Journal of Neuroimaging and Interventional Neurology. R. Nogueira: Other; Modest; Stryker Neurovascular (PI for TREVO-2 and DAWN Trials), Covidien (Steering Committee for SWIFT and SWIFT Trials; Core Lab for STAR Trial), Penumbra (Executive Committe for 3D Separator Trial), Rapid M. M. Frankel: None. M. Mlynash: None. M. Lansberg: None. G. Albers: None. A.P. Jadhav: None. T.G. Jovin: Other; Modest; received consulting and speaker fees from Co-Axia, ev3, Concentric Medical, and Micrus..
- © 2014 by American Heart Association, Inc.