This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To develop a simple prognostic model to predict outcome at 1 month after acute basilar artery occlusion (BAO) with readily available predictors.
Methods: The Basilar Artery International Cooperation Study (BASICS) is a prospective, observational, international registry of consecutive patients who presented with an acute symptomatic and radiologically confirmed BAO. We considered predictors available at hospital admission in multivariable logistic regression models to predict poor outcome (modified Rankin Scale [mRS] score 4–5 or death) at 1 month. We used receiver operator characteristic curves to assess the discriminatory performance of the models.
Results: Of the 619 patients, 429 (69%) had a poor outcome at 1 month: 74 (12%) had a mRS score of 4, 115 (19%) had a mRS score of 5, and 240 (39%) had died. The main predictors of poor outcome were older age, absence of hyperlipidemia, presence of prodromal minor stroke, higher NIH Stroke Scale (NIHSS) score, and longer time to treatment. A prognostic model that combined demographic data and stroke risk factors had an area under the receiver operating characteristic curve (AUC) of 0.64. This performance improved by including findings from the neurologic examination (AUC 0.79) and CT imaging (AUC 0.80). A risk chart showed predictions of poor outcome at 1 month varying from 25 to 96%.
Conclusion: Poor outcome after BAO can be reliably predicted by a simple model that includes older age, absence of hyperlipidemia, presence of prodromal minor stroke, higher NIHSS score, and longer time to treatment.
GLOSSARY
- AUC=
- area under the receiver operating characteristic curve;
- BAO=
- basilar artery occlusion;
- BASICS=
- Basilar Artery International Cooperation Study;
- mRS=
- modified Rankin Scale;
- NIHSS=
- NIH Stroke Scale
Footnotes
-
Coinvestigators of the BASICS Study Group are listed on the Neurology® Web site at www.neurology.org.
-
Study funding: This study was funded by an unconditional grant from the Brain Foundation of the Netherlands (grant 2010(2).01). The development of the BASICS registry was supported by the Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands.
Supplemental data at www.neurology.org
- Received August 12, 2011.
- Accepted November 17, 2011.
- Copyright © 2012 by AAN Enterprises, Inc.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
- Respective prediction models for respective treatment managements
- Re: Respective prediction models for respective treatment managements
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
Neutrophil count predicts poor outcome despite recanalization after endovascular therapy
Frequency of early rapid improvement in stroke severity during interfacility transfer
MRI-based thrombolytic therapy in patients with acute ischemic stroke presenting with a low NIHSS
Patient outcomes from symptomatic intracerebral hemorrhage after stroke thrombolysis