Your browser doesn't support javascript.
loading
How Do Quantitative Tissue Imaging Outcomes in Acute Ischemic Stroke Relate to Clinical Outcomes?
Ospel, Johanna M; Rinkel, Leon; Ganesh, Aravind; Demchuk, Andrew; Heran, Manraj; Sauvageau, Eric; Joshi, Manish; Haussen, Diogo; Jayaraman, Mahesh; Coutts, Shelagh; Yu, Amy; Puetz, Volker; Iancu, Dana; Bang, Oh Young; Tarpley, Jason; Holmin, Staffan; Kelly, Michael; Tymianski, Michael; Hill, Michael; Goyal, Mayank.
Afiliación
  • Ospel JM; Department of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
  • Rinkel L; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
  • Ganesh A; Department of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
  • Demchuk A; Department of Neurology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands.
  • Heran M; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
  • Sauvageau E; Department of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
  • Joshi M; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
  • Haussen D; Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
  • Jayaraman M; Lyerly Neurosurgery, Baptist Hospital, Jacksonville, FL, USA.
  • Coutts S; Department of Diagnostic Imaging, University of Calgary, Calgary, AB, Canada.
  • Yu A; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
  • Puetz V; Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA.
  • Iancu D; Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
  • Bang OY; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
  • Tarpley J; University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
  • Holmin S; University Hospital Carl Gustav Carus at the Technische Universität Dresden, Department of Neurology and Dresden Neurovascular Center, Dresden, Germany.
  • Kelly M; Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
  • Tymianski M; Department of Neurology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
  • Hill M; Providence Little Company of Mary Medical Center, Providence Saint John's Health Center and The Pacific Neuroscience Institute, Torrance, CA, USA.
  • Goyal M; Department of Clinical Neuroscience, Karolinska Institutet and Departments of Neuroradiology and Neurology, Karolinska University Hospital, Stockholm, Sweden.
J Stroke ; 26(2): 252-259, 2024 May.
Article en En | MEDLINE | ID: mdl-38836272
ABSTRACT
BACKGROUND AND

PURPOSE:

Infarct volume and other imaging markers are increasingly used as surrogate measures for clinical outcome in acute ischemic stroke research, but how improvements in these imaging surrogates translate into better clinical outcomes is currently unclear. We investigated how changes in infarct volume at 24 hours alter the probability of achieving good clinical outcome (modified Rankin Scale [mRS] 0-2).

METHODS:

Data are from endovascular thrombectomy patients from the randomized controlled ESCAPE-NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischaemic Stroke) trial. Infarct volume at 24 hours was manually segmented on non-contrast computed tomography or diffusion-weighted magnetic resonance imaging. Probabilities of achieving good outcome based on infarct volume were obtained from a multivariable logistic regression model. The probability of good outcome was plotted against infarct volume using linear spline regression.

RESULTS:

A total of 1,099 patients were included in the analysis (median final infarct volume 24.9 mL [interquartile range 6.6-92.2]). The relationship between total infarct volume and good outcome probability was nearly linear for infarct volumes between 0 mL and 250 mL. In this range, a 10% increase in the probability of achieving mRS 0-2 required a decrease in infarct volume of approximately 34.0 mL (95% confidence interval -32.5 to -35.6). At infarct volumes above 250 mL, the probability of achieving mRS 0-2 probability was near zero. The relationships of tissue-specific infarct volumes and parenchymal hemorrhage volume generally showed similar patterns, although variability was high.

CONCLUSION:

There seems to be a near-linear association between total infarct volume and probability of achieving good outcome for infarcts up to 250 mL, whereas patients with infarct volumes greater than 250 mL are highly unlikely to have a favorable outcome.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Stroke Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación:
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Stroke Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: