DWI-Based Algorithm to Predict Disability in Patients Treated with Thrombectomy for Acute Stroke

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FIG 1.
Flow chart.
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FIG 2.
Receiver operating characteristic curve of the logistic model for prediction of poor prognosis: area under curve = 0.87.
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FIG 3.
Hierarchic algorithm based on the 4 independent variables from the multivariate analysis for predicting poor prognosis at 3 months after thrombectomy. The algorithm shows the percentage of poor prognoses (mRS > 2 at 3 months) predicted with the model and the corresponding number of cases observed in our population.

Table 1:

Characteristics of the study population^{^a}

Variable	Total (n = 149)	Good Prognosis: mRS at 3 Months ≤ 2 (n = 69)	Poor Prognosis: mRS at 3 Months >2 (n = 80)	P Value
Age (yr)	68.7 ± 14.3	65.8 ± 15.1	71.2 ± 13.2	.022
Sex ratio (female/male)	71:78	32:37	39:41	.772
Diabetes mellitus	15 (10.1%)	4 (5.8%)	11 (13.8%)	.108
Arterial hypertension	88 (59.1%)	33 (47.8%)	55 (68.8%)	.010
Atrial fibrillation	37 (24.8%)	10 (14.5%)	27 (33.8%)	.007
History of stroke or transient ischemic attack	25 (16.8%)	8 (11.6%)	17 (21.3%)	.116
Prestroke mRS				.670
0	137 (91.9%)	65 (94.2%)	72 (90.0%)
1	10 (6.7%)	3 (4.3%)	7 (8.8%)
2	2 (1.3%)	1 (1.4%)	1 (1.3%)
Systolic blood pressure (mm Hg)	153.4 ± 27.6	155.7 ± 28.3	151.3 ± 27.0	.372
Blood glucose level (mmol/L)	6.9 ± 2.2	6.3 ± 1.3	7.4 ± 2.6	.001
Baseline NIHSS score	16.3 ± 5.4	13.8 ± 5.6	18.5 ± 4.2	< .001
DWI-ASPECTS	5.9 ± 2.7	7.1 ± 2.1	4.9 ± 2.7	< .001
DWI volume (mL)	53.3 ± 64.8	23.8 ± 18.7	81.1 ± 79.2	< .001
Occlusion location				< .001
M1	95 (63.8%)	45 (65.2%)	50 (62.5%)
M2	21 (14.1%)	18 (26.1%)	3 (3.8%)
Terminal ICA	33 (22.1%)	6 (8.7%)	27 (33.8%)
Intravenous alteplase	115 (77.2%)	60 (87.0%)	55 (68.8%)	.008
Stroke side				.304
Left	65 (43.6%)	27 (39.1%)	38 (47.5%)
Right	84 (56.4%)	42 (60.9%)	42 (52.5%)
Time from stroke onset to groin puncture (hr)	3.9 ± 1.3	3.6 ± 1.2	4.2 ± 1.3	.002
Recanalization score				.019
TICI 2b/3	122 (81.9%)	62 (89.9%)	60 (75.0%)
TICI 0/1/2a	27 (18.1%)	7 (10.1%)	20 (25.0%)
Anesthesia				.032
Conscious sedation	68 (45.6%)	38 (55.1%)	30 (37.5%)
General anesthesia	81 (54.4%)	31 (44.9%)	50 (62.5%)

↵a Quantitative variables are expressed as means; qualitative variables are expressed as numbers (corresponding percentage).

Table 2:

Variables independently associated with poor prognosis identified in logistic regression analysis

Variables	Odds Ratio (95% CI)	P Value
DWI lesion volume >80 mL	37.47 (4.62–303.63)	.0007
NIHSS score >14	5.84 (2.20–15.52)	.0004
Age older than 75 yr	6.15 (2.35–16.11)	.0002
Time from stroke onset to groin puncture (hr)	2.55 (1.02–6.39)	.0456