Predicting long-term outcome after endovascular stroke treatment: the totaled health risks in vascular events score.
OBJECTIVE
Endovascular treatments are being increasingly used in acute ischemic stroke, and better tools are needed to determine which patients may benefit most from these techniques. We hypothesized that specific chronic diseases can be used, along with age and stroke severity, to predict endovascular stroke treatment outcomes.


METHODS
Data from 2 single-arm trials of a thrombectomy device, MERCI and Multi MERCI, were pooled for analysis. A predictive score was developed by using the independent contribution of variables in multivariable analysis.


RESULTS
HTN, DM, and AFib were found to predict outcomes. These 3 conditions contribute equally to a CDS that predicts outcomes independent of other predictor variables, including age, stroke severity, and vessel recanalization. A 10-level predictive score, the THRIVE score, which incorporates age, stroke severity, and the CDS, was developed. The THRIVE score strongly predicts outcome and mortality at 90 days.


CONCLUSIONS
Specific chronic diseases influence poststroke outcomes among patients undergoing endovascular stroke treatment, independent of other predictors of outcome. The THRIVE score reflects the contributions of chronic disease, age, and stroke severity and strongly predicts endovascular stroke treatment outcomes.
Department of Neurocritical Care and Stroke, Regional Neuroscience Program, Kaiser Permanente Northern California, Redwood City, California 94063, USA. alexander.c.flint@kp.org
Alexander C
AC
Flint
S P
SP
Cullen
B S
BS
Faigeles
V A
VA
Rao
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002545:Brain Ischemia / Q000401:mortality* / Q000601:surgery*; D002908:Chronic Disease; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000401:mortality* / Q000601:surgery*; D017131:Thrombectomy / Q000401:mortality*; D016896:Treatment Outcome