Abstract W MP10: The Prognostic Value of Age and NIH Stroke Scale in Predicting the Outcomes of Endovascular Stroke Therapy in the STAR Registry; Validation of the SPAN-100 score
Background: Age and stroke severity are inversely correlated with the odds of favorable outcome after ischemic stroke. The Stroke Prognostication using Age and NIH Stroke Scale (SPAN) index identified that patients with a SPAN index 100 or more (SPAN-100 positive) did not benefit from IV tPA in the NINDS trial. The effect of successful reperfusion on the prognostic value of this score is not known.
Methods: The SPAN index was calculated for patients in the prospective Solitaire FR Thrombectomy for Acute Revascularisation "STAR" study: an international single-arm multi center cohort for anterior circulation stroke. The proportion with favorable outcome (90-day mRS score ≤ 2) was compared between SPAN-100 positive vs. negative patients.
Results: Of the 202 patients enrolled, 196 had non-missing baseline NIHSS. Fifteen (7.7%) patients were SPAN -100 positive. There was no difference in the rate of successful reperfusion (TICI2b or 3) between SPAN-100 positive vs. negative groups (93.3% vs. 82.8% respectively, p=0.3). SPAN-100 positive patients had a significantly lower proportion of favorable clinical outcome (26.7% vs. 60.8% in SPAN-100 negative, p=0.01) (Figure). In a univariable analysis, SPAN-100 positive status was associated with lower odds of favorable outcome (OR 0.23, CI95 0.07 to 0.77; p=0.02). In a multivariable logistic regression, only baseline ASPECTS and time from onset to revascularization were significant predictors of favorable outcome.
Conclusion: A significantly lower proportion of patients with a positive SPAN-100 index achieved favorable outcome at 90 days. In our cohort, this effect was accounted for by delays in the time from onset to revascularization.
Author Disclosures: M.A. Almekhlafi: None. A. Davalos: None. A. Bonafe: None. R. Chapot: Consultant/Advisory Board; Modest; consultant for Covidien, Microvention and Balt. J. Gralla: Research Grant; Modest; global PI STAR. Consultant/Advisory Board; Modest; consultant for Covidien. V.M. Pereira: Research Grant; Modest; global PI STAR. Consultant/Advisory Board; Modest; consultant for Covidien. M. Goyal: Speakers' Bureau; Modest; Covidien EV3. Research Grant; Significant; Institutional grant for ESCAPE trial from Covidien EV3. Consultant/Advisory Board; Significant; Covidien EV3 for help with design and execution of SWIFT PRIME.
- © 2014 by American Heart Association, Inc.