Abstract T P39: Serial Alberta Stroke Program Early Ct Score (aspects) Is A Superior Predictor Of Outcomes With Iv Rtpa
Background and purpose: The Alberta stroke program early computed tomography score (ASPECTS) on baseline imaging is known predictor of outcomes for acute ischemic stroke (AIS) patients. We looked at the change in ASPECTS at the baseline CT and 24hr CT in AIS patients treated with IV rTPA to determine if it can help predict 3 month functional outcomes.
Methods: Consecutive AIS patients receiving IV-tPA within 4.5 hours of symptom-onset during 2010-2013 and underwent pre-treatment and day-2 CT were included ASPECTS at the baseline CT and 24hr CT were independently scored in all anterior circulation stroke patients who underwent IV rTPA within 4.5 hours of onset. ASPECTS at baseline, 24hrs and the serial change were analyzed.
Results: 210 consecutive AIS patients were included. ROC curves for ASPECTS on the initial CT scan for MRS 0-1 was AUC 0.613, 95% CI 0.536-0.690, p=0.005, while ROC curves for ASPECTS on the 24hr CT scan for MRS0-1 was AUC 0.763 95% CI 0.699 - 0.828, p <0.001. ASPECTS on the 24hr CT was statistically significantly better able to predict outcomes compared to the initial CT (z= -2.936, p = 0.001). 28 out of 210 patients had an increase in ASPECTS by >3 with a 3-fold risk of worse outcomes (OR 3.572 95%CI 1.393- 9.156, p=0.08).
Conclusion: ASPECT scores on 24hr CT have better prognostic ability compared to the baseline scan. Serial ASPECT scores are a viable surrogate predictor in AIS patients treated with IV rTPA.
Author Disclosures: L. Yeo: Research Grant; Significant; NMRC. P. Paliwal: None. H. Teoh: None. B. Chan: None. R. Seet: None. V. Sharma: None.
- © 2015 by American Heart Association, Inc.