Abstract
BACKGROUND: The applicability of the current models for predicting functional outcome after thrombectomy in strokes with large vessel occlusion (LVO) is affected by a moderate predictive performance.
AIMS: We aimed to develop and validate a nomogram with pre- and post-treatment factors for prediction of the probability of unfavorable outcome in patients with anterior and posterior LVO who received bridging therapy or direct thrombectomy <6 h of stroke onset.
METHODS: We conducted a cohort study on patients data collected prospectively in the Italian Endovascular Registry (IER). Unfavorable outcome was defined as three-month modified Rankin Scale (mRS) score 3-6. Six predictors, including NIH Stroke Scale (NIHSS) score, age, pre-stroke mRS score, bridging therapy or direct thrombectomy, grade of recanalization according to the thrombolysis in cerebral ischemia (TICI) grading system, and onset-to-end procedure time were identified a priori by three stroke experts. To generate the IER-START, the pre-established predictors were entered into a logistic regression model. The discriminative performance of the model was assessed by using the area under the receiver operating characteristic curve (AUC-ROC).
RESULTS: A total of 1802 patients with complete data for generating the IER-START was randomly dichotomized into training ( n = 1219) and test ( n = 583) sets. The AUC-ROC of IER-START was 0.838 (95% confidence interval [CI]): 0.816-0.869) in the training set, and 0.820 (95% CI: 0.786-0.854) in the test set.
CONCLUSIONS: The IER-START nomogram is the first prognostic model developed and validated in the largest population of stroke patients currently candidates to thrombectomy which reliably calculates the probability of three-month unfavorable outcome.
| Original language | English |
|---|---|
| Pages (from-to) | 1747493019837756 |
| Journal | International Journal of Stroke |
| DOIs | |
| Publication status | E-pub ahead of print - Mar 25 2019 |
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IER-START nomogram for prediction of three-month unfavorable outcome after thrombectomy for stroke. / Cappellari, Manuel; Mangiafico, Salvatore; Saia, Valentina; Pracucci, Giovanni; Nappini, Sergio; Nencini, Patrizia; Konda, Daniel; Sallustio, Fabrizio; Vallone, Stefano; Zini, Andrea; Bracco, Sandra; Tassi, Rossana; Bergui, Mauro; Cerrato, Paolo; Pitrone, Antonio; Grillo, Francesco; Saletti, Andrea; De Vito, Alessandro; Gasparotti, Roberto; Magoni, Mauro; Puglielli, Edoardo; Casalena, Alfonsina; Causin, Francesco; Baracchini, Claudio; Castellan, Lucio; Malfatto, Laura; Menozzi, Roberto; Scoditti, Umberto; Comelli, Chiara; Duc, Enrica; Comai, Alessio; Franchini, Enrica; Cosottini, Mirco; Mancuso, Michelangelo; Peschillo, Simone; De Michele, Manuela; Giorgianni, Andrea; Luisa Delodovici, Maria; Lafe, Elvis; Denaro, Maria F; Burdi, Nicola; Internò, Saverio; Cavasin, Nicola; Critelli, Adriana; Chiumarulo, Luigi; Petruzzellis, Marco; Doddi, Marco; Carolei, Antonio; Auteri, William; Petrone, Alfredo; Padolecchia, Riccardo; Tassinari, Tiziana; Pavia, Marco; Invernizzi, Paolo; Turcato, Gianni; Forlivesi, Stefano; Francesca Maria Ciceri, Elisa; Bonetti, Bruno; Inzitari, Domenico; Toni, Danilo.
In: International Journal of Stroke, 25.03.2019, p. 1747493019837756.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - IER-START nomogram for prediction of three-month unfavorable outcome after thrombectomy for stroke
AU - Cappellari, Manuel
AU - Mangiafico, Salvatore
AU - Saia, Valentina
AU - Pracucci, Giovanni
AU - Nappini, Sergio
AU - Nencini, Patrizia
AU - Konda, Daniel
AU - Sallustio, Fabrizio
AU - Vallone, Stefano
AU - Zini, Andrea
AU - Bracco, Sandra
AU - Tassi, Rossana
AU - Bergui, Mauro
AU - Cerrato, Paolo
AU - Pitrone, Antonio
AU - Grillo, Francesco
AU - Saletti, Andrea
AU - De Vito, Alessandro
AU - Gasparotti, Roberto
AU - Magoni, Mauro
AU - Puglielli, Edoardo
AU - Casalena, Alfonsina
AU - Causin, Francesco
AU - Baracchini, Claudio
AU - Castellan, Lucio
AU - Malfatto, Laura
AU - Menozzi, Roberto
AU - Scoditti, Umberto
AU - Comelli, Chiara
AU - Duc, Enrica
AU - Comai, Alessio
AU - Franchini, Enrica
AU - Cosottini, Mirco
AU - Mancuso, Michelangelo
AU - Peschillo, Simone
AU - De Michele, Manuela
AU - Giorgianni, Andrea
AU - Luisa Delodovici, Maria
AU - Lafe, Elvis
AU - Denaro, Maria F
AU - Burdi, Nicola
AU - Internò, Saverio
AU - Cavasin, Nicola
AU - Critelli, Adriana
AU - Chiumarulo, Luigi
AU - Petruzzellis, Marco
AU - Doddi, Marco
AU - Carolei, Antonio
AU - Auteri, William
AU - Petrone, Alfredo
AU - Padolecchia, Riccardo
AU - Tassinari, Tiziana
AU - Pavia, Marco
AU - Invernizzi, Paolo
AU - Turcato, Gianni
AU - Forlivesi, Stefano
AU - Francesca Maria Ciceri, Elisa
AU - Bonetti, Bruno
AU - Inzitari, Domenico
AU - Toni, Danilo
PY - 2019/3/25
Y1 - 2019/3/25
N2 - BACKGROUND: The applicability of the current models for predicting functional outcome after thrombectomy in strokes with large vessel occlusion (LVO) is affected by a moderate predictive performance.AIMS: We aimed to develop and validate a nomogram with pre- and post-treatment factors for prediction of the probability of unfavorable outcome in patients with anterior and posterior LVO who received bridging therapy or direct thrombectomy <6 h of stroke onset.METHODS: We conducted a cohort study on patients data collected prospectively in the Italian Endovascular Registry (IER). Unfavorable outcome was defined as three-month modified Rankin Scale (mRS) score 3-6. Six predictors, including NIH Stroke Scale (NIHSS) score, age, pre-stroke mRS score, bridging therapy or direct thrombectomy, grade of recanalization according to the thrombolysis in cerebral ischemia (TICI) grading system, and onset-to-end procedure time were identified a priori by three stroke experts. To generate the IER-START, the pre-established predictors were entered into a logistic regression model. The discriminative performance of the model was assessed by using the area under the receiver operating characteristic curve (AUC-ROC).RESULTS: A total of 1802 patients with complete data for generating the IER-START was randomly dichotomized into training ( n = 1219) and test ( n = 583) sets. The AUC-ROC of IER-START was 0.838 (95% confidence interval [CI]): 0.816-0.869) in the training set, and 0.820 (95% CI: 0.786-0.854) in the test set.CONCLUSIONS: The IER-START nomogram is the first prognostic model developed and validated in the largest population of stroke patients currently candidates to thrombectomy which reliably calculates the probability of three-month unfavorable outcome.
AB - BACKGROUND: The applicability of the current models for predicting functional outcome after thrombectomy in strokes with large vessel occlusion (LVO) is affected by a moderate predictive performance.AIMS: We aimed to develop and validate a nomogram with pre- and post-treatment factors for prediction of the probability of unfavorable outcome in patients with anterior and posterior LVO who received bridging therapy or direct thrombectomy <6 h of stroke onset.METHODS: We conducted a cohort study on patients data collected prospectively in the Italian Endovascular Registry (IER). Unfavorable outcome was defined as three-month modified Rankin Scale (mRS) score 3-6. Six predictors, including NIH Stroke Scale (NIHSS) score, age, pre-stroke mRS score, bridging therapy or direct thrombectomy, grade of recanalization according to the thrombolysis in cerebral ischemia (TICI) grading system, and onset-to-end procedure time were identified a priori by three stroke experts. To generate the IER-START, the pre-established predictors were entered into a logistic regression model. The discriminative performance of the model was assessed by using the area under the receiver operating characteristic curve (AUC-ROC).RESULTS: A total of 1802 patients with complete data for generating the IER-START was randomly dichotomized into training ( n = 1219) and test ( n = 583) sets. The AUC-ROC of IER-START was 0.838 (95% confidence interval [CI]): 0.816-0.869) in the training set, and 0.820 (95% CI: 0.786-0.854) in the test set.CONCLUSIONS: The IER-START nomogram is the first prognostic model developed and validated in the largest population of stroke patients currently candidates to thrombectomy which reliably calculates the probability of three-month unfavorable outcome.
U2 - 10.1177/1747493019837756
DO - 10.1177/1747493019837756
M3 - Article
C2 - 30907302
SP - 1747493019837756
JO - International Journal of Stroke
JF - International Journal of Stroke
SN - 1747-4930
ER -