Title
Clinical, biochemical and neuroimaging parameters after thrombolytic therapy predict long-term stroke outcome Clinical, biochemical and neuroimaging parameters after thrombolytic therapy predict long-term stroke outcome
Author
Faculty/Department
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences . Biomedical Sciences
Publication type
article
Publication
Basel ,
Subject
Human medicine
Source (journal)
European neurology. - Basel
Volume/pages
62(2009) :1 , p. 9-15
ISSN
0014-3022
ISI
000266343000002
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Introduction: We investigated the predictive value of standard neurological evaluation, a commercially available biomarker assay and neuroimaging in the subacute phase for outcome after thrombolytic therapy in ischemic stroke. Methods: Thirty-four consecutive ischemic stroke patients were evaluated by means of the NIH Stroke Scale (NIHSS<sub>72</sub>), the Triage® Stroke Panel (MMX<sub>72</sub>) and standardized infarct volumetry at 72 h after treatment with intravenous recombinant tissue plasminogen activator or intra-arterial urokinase. Outcome was assessed by the modified Rankin Scale (mRS) at 3 months after the stroke. Results: NIHSS<sub>72</sub>, MMX<sub>72</sub> and infarct volume correlated significantly with the mRS score at month 3 and emerged as independent outcome predictors from logistic regression analysis. NIHSS<sub>72</sub> is the best predictor for outcome, but its accuracy increases by 9 and 6% when combined with MMX<sub>72</sub> and infarct volumetry, respectively. The combined use of NIHSS<sub>72</sub> and MMX<sub>72</sub> allows long-term outcome prediction with 97% accuracy, which is not further improved by infarct volumetry. Conclusions: Routine clinical evaluation, bedside testing of biochemical markers by the Triage Stroke Panel and infarct volumetry on neuroimaging at 72 h after thrombolytic therapy are predictors for long-term outcome of ischemic stroke patients. Clinical assessment is the most reliable parameter for outcome prediction, but its predictive value is substantially improved when combined with the biomarker panel.
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