PT - JOURNAL ARTICLE AU - Raoult, H. AU - Lassalle, M.V. AU - Parat, B. AU - Rousseau, C. AU - Eugène, F. AU - Vannier, S. AU - Evain, S. AU - Le Bras, A. AU - Ronziere, T. AU - Ferre, J.C. AU - Gauvrit, J.Y. AU - Laviolle, B. TI - DWI-Based Algorithm to Predict Disability in Patients Treated with Thrombectomy for Acute Stroke AID - 10.3174/ajnr.A6379 DP - 2020 Jan 30 TA - American Journal of Neuroradiology 4099 - http://www.ajnr.org/content/early/2020/01/30/ajnr.A6379.short 4100 - http://www.ajnr.org/content/early/2020/01/30/ajnr.A6379.full AB - BACKGROUND AND PURPOSE: The reasons for poor clinical outcome after thrombectomy for acute stroke, concerning around half of all patients, are misunderstood. We developed a hierarchic algorithm based on DWI to better identify patients at high risk of disability.MATERIALS AND METHODS: Our single-center, retrospective study included consecutive patients with acute ischemic stroke who underwent thrombectomy for large anterior artery occlusion and underwent pretreatment DWI. The primary outcome was the mRS at 3 months after stroke onset. Multivariable regression was used to identify independent clinical and imaging predictors of poor prognosis (mRS > 2) at 3 months, and a hierarchic algorithm predictive of disability was developed.RESULTS: A total of 149 patients were analyzed. In decreasing importance, DWI lesion volume of >80 mL, baseline NIHSS score of >14, age older than 75 years, and time from stroke onset to groin puncture of >4 hours were independent predictors of poor prognosis. The predictive hierarchic algorithm developed from the multivariate analysis predicted the risk of disability at 3 months for up to 100% of patients with a high predictive value. The area under the receiver operating characteristic curve was 0.87.CONCLUSIONS: The DWI-based hierarchic algorithm we developed is highly predictive of disability at 3 months after thrombectomy and is easy to use in routine practice.