Abstract W P24: Validation of the Interventional Stroke Assessment Scale for Eligibility in Endovascular Therapy (ISAS-ET)
Background: Despite innovations in endovascular stroke treatment, less than 55% of patients have shown good outcomes in multiple randomized clinical trials. In this study we are validating the Interventional Stroke Assessment Scale for Eligibility in Endovascular Therapy (ISAS-ET).
Materials: This is a retrospective analysis of all patients (n= 111) who presented to our hospital with ischemic stroke and received advanced stroke treatment between January 2013 and July 2014. Statistical analysis was performed using GraphPad Prism. The scoring system was developed with a score range (0-8), where a high score predicts a better outcome. Patients received 2,1,0 points for collateral scores of 3-4, 2, 0-1 respectively; patients received 2, 1, 0 points for NIHSS scores of 0-10, 11-20 and over 21 respectively; age <65 received 1 point; absence of AFib received 1 point; time of onset <3 hours received 1 point; no prior stroke or disability received 1 point. Statistical analysis was performed using GraphPad Prism. A modified rankin scale (mRS) of 2 or less represented a good functional outcome. Mortality was defined as a mRS score of 6 and good disposition was defined as patient discharged to home or inpatient rehabilitation. All variables were included in the analysis.
Results: Results for 59 patients included in this study are as follows: 61% female, mean age 74.0 ± 19.1, mean NIHSS 17.8 ± 7.2, 49.1% AFib and 10.1% mortality. We found a significant correlation between the ISAS-ET score and outcome (95% CI, 3.36-4.24, P < 0.001), mortality (95% CI, 3.93-4.82, P < 0.001) as well as good disposition (95% CI, 3.68-4.56, P < 0.001). Of this group, 94% of the patients with an ISAS-ET score of 1, 2 or 3 had a poor outcome regardless of intervention. Conversely, 86% of the patients with a score of 7 or more had a good outcome.
Conclusion: The ISAS-ET scale appears to be appropriate in this single center study at predicting outcome using parameters prior to intervention. This data may help determine the urgency of transfer for intervention in hospitals without endovascular capabilities while helping determine which patients will benefit significantly from intervention. We plan to validate these results in a prospective study.
Author Disclosures: H. Dababneh: None. S. Sakian: None. H. Zheng: None. R. Kumar: None. S. Azhar: None. K. Arcot: None. A. Tiwari: None. J. Farkas: None.
- © 2015 by American Heart Association, Inc.