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Utility of A2L2 score in acute ischemic stroke patient triage: the "H.uni" experience.
Scoppettuolo, Pasquale; Raymackers, Jean-Marc; Rutgers, Matthieu Pierre; Poma, Jean-François; Goffette, Pierre; Hammer, Frank; Peeters, André.
Afiliación
  • Scoppettuolo P; Neurology Department - Cliniques Universitaires Saint Luc, H.uni - UCLouvain, Brussels, Belgium. Pasquale.scoppettuolo@gmail.com.
  • Raymackers JM; Neurology Department - Clinique Saint-Pierre Ottignies, H.uni - UCLouvain, Ottignies, Belgium.
  • Rutgers MP; Neurology Department - Europe Hospitals, H.uni - UCLouvain, Brussels, Belgium.
  • Poma JF; Neurology Department - Clinique Saint Jean, H.uni - UCLouvain, Brussels, Belgium.
  • Goffette P; Radiology Department - Cliniques, Universitaires Saint Luc, H.uni - UCLouvain, Brussels, Belgium.
  • Hammer F; Radiology Department - Cliniques, Universitaires Saint Luc, H.uni - UCLouvain, Brussels, Belgium.
  • Peeters A; Neurology Department - Cliniques Universitaires Saint Luc, H.uni - UCLouvain, Brussels, Belgium.
Acta Neurol Belg ; 2024 Jun 27.
Article en En | MEDLINE | ID: mdl-38935263
ABSTRACT
BACKGROUND AND

AIMS:

Two or more National Institutes of Health Stroke Scale (NIHSS) points on each motor items (A2L2 score) have shown good accuracy in predicting large vessel occlusion (LVO) in the prehospital setting of acute ischemic stroke (AIS) care. We aimed to study this score for LVO prediction in our stroke network and predictors of poor outcome (PO) after mechanical thrombectomy (MT).

METHODS:

From our Safe Implementation of Thrombolysis in Stroke (SITS) registry including patients receiving reperfusion therapy for AIS, we retrospectively computed the A2L2 score from the admission NIHSS to test the diagnostic accuracy for LVO prediction. Multivariable analysis for independent predictors of LVO on the entire cohort and PO from patients with LVO were performed.

RESULTS:

From the 853 patients with AIS (67% LVO), A2L2 was positive in 52%. A2L2 score (Odds ratio [OR] 4.6;95%CI 3.36-6.34), smoking (OR 2.1;95%CI 1.14-3.85), atrial fibrillation (OR 1.6;95%CI1.1-2.4) and younger age (OR 0.98;95%CI0.97-0.99) were independent predictors of LVO. A2L2 score showed 82%/49% positive/negative predictive values with 66% accuracy (64%/72% sensitivity/specificity) for LVO prediction. Age (OR 1.05;95%CI 1.03-1.07), atrial fibrillation (OR 4.85;95%CI 1.5-15.7), diabetes (OR 2.62;95% CI 1.14-6.05), dyslipidemia (OR 2;95% CI 1.04-3.87), A2L2 score (OR 2.68;95% CI 1.45-4.98), longer onset-to-groin time (OR 1.003;95% CI 1.001-1.01), MT procedure (OR 1.01;95%CI 1.003-1.02) general anaesthesia (OR 2.06;95% CI 1.1-3.83) and symptomatic intracranial hemorrhage (OR 12.10;95%CI 3.15-46.44) were independent predictors of PO.

CONCLUSIONS:

A2L2 score independently predicted LVO and PO after MT. Patient characteristics and procedural factors determined PO of LVO patients after MT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Acta Neurol Belg Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Italia
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: Acta Neurol Belg Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Italia