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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(12): 986-989
DOI: 10.1590/0004-282X20160152
ARTICLE

Simple prediction model for unfavorable outcome in ischemic stroke after intravenous thrombolytic therapy

Modelo simples de predição de desfecho desfavorável em acidente vascular cerebral isquêmico tratado após terapia trombolítica intravenosa
Daniel Amitrano
1   Hospital Copa D´Or, Unidade de Cuidado Neurointensivo, Rio de Janeiro RJ, Brasil;
2   Universidade Federal Fluminense, Departamento de Neurologia, Rio de Janeiro RJ, Brasil;
,
Ivan Rocha Ferreira da Silva
2   Universidade Federal Fluminense, Departamento de Neurologia, Rio de Janeiro RJ, Brasil;
3   Unidade Neurointensiva, Americas Medical Center, Rio de Janeiro, Brazil.
,
Bernardo B. Liberato
1   Hospital Copa D´Or, Unidade de Cuidado Neurointensivo, Rio de Janeiro RJ, Brasil;
3   Unidade Neurointensiva, Americas Medical Center, Rio de Janeiro, Brazil.
,
Valéria Batistella
1   Hospital Copa D´Or, Unidade de Cuidado Neurointensivo, Rio de Janeiro RJ, Brasil;
,
Janaina Oliveira
1   Hospital Copa D´Or, Unidade de Cuidado Neurointensivo, Rio de Janeiro RJ, Brasil;
,
Osvaldo J. M. Nascimento
2   Universidade Federal Fluminense, Departamento de Neurologia, Rio de Janeiro RJ, Brasil;
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ABSTRACT

Objective

We aimed to develop a model to predict unfavorable outcome in patients with acute ischemic stroke treated with intravenous thrombolytic therapy (IVT), based on simple variables present on admission.

Methods

Retrospective analysis of acute ischemic stroke patients treated with IVT in a hospital in Rio de Janeiro. Clinical and radiographic variables were selected for analysis. Multivariate logistic regression was used to develop a predictive model.

Results

We analyzed a total of 82 patients. Median National Institutes of Health Stroke Scale (NIHSS) on admission was 9 (3–22), 40.2% presented with a hyperdense artery sign (HAS), 62% had identifiable early parenchymal changes and 61.6% experienced a favorable outcome. An NIHSS score of > 12 on arrival, age > 70 and the presence of HAS were associated with the outcome, even after correction in a logistic regression model.

Conclusion

An NIHSS > 12 on arrival, presence of HAS and age > 70 years were predictors of unfavorable outcome at three months in patients with acute ischemic stroke treated with IVT.

RESUMO

Objetivo

Desenvolver um modelo para predizer desfecho desfavorável em pacientes com acidente vascular cerebral isquêmico (AVCi) agudo tratados com terapia trombolítica intravenosa (TTI), baseado em variáveis simples presentes à admissão.

Métodos

Análise retrospectiva de casos de AVCi tratados com TTI em um hospital no Rio de Janeiro. Variáveis clínicas e radiográficas foram selecionadas para análise. Foi utilizada regressão logística para desenvolver modelo preditivo.

Resultados

82 casos foram analisados. A mediana de escore de National Institutes of Health Stroke Scale (NIHSS) na admissão foi 9 (3–22), 40,2% se apresentaram com sinal da artéria hiperdensa (SAH), 62% possuíam alterações parenquimatosas precoces e 61,6% obtiveram um desfecho favorável. NIHSS > 12, idade > 70 e a presença de SAH foram associados com o desfecho, mesmo após correção em modelo de regressão logística.

Conclusão

NIHSS > 12, a presença de SAH e idade maior que 70 anos foram preditores de desfecho desfavorável em 3 meses em pacientes com AVCi tratados com TTI.

stroke - thrombolytic therapy - forecasting
acidente vascular cerebral - terapia trombolítica - previsões


Publication History

Received: 21 March 2016

Accepted: 24 August 2016

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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