title: A simple clinical and MRI scale to predict good outcome in t-PA patients.
abstract: OBJECTIVE
  The frequency of good outcome at 3 months after tissue plasminogen activator (t-PA) therapy is ∼35%. The present study aimed to devise a simple scale to predict good outcome using clinical factors and magnetic resonance imaging (MRI)  findings before and immediately after t-PA infusion.
  
  
  METHODS
  Consecutive patients with acute ischemic stroke treated with t-PA within 3 hours of stroke onset were studied prospectively. We assessed clinical factors independently associated with good outcome [modified Rankin scale  (mRS): 0-1] at 3 months after t-PA therapy. We created a simple scale to predict good outcome in t-PA patients using factors selected by multivariate logistic regression analysis.
  
  
  RESULTS
  Subjects comprised 105 patients (69 men; median age, 74 years). Multivariate logistic  regression analysis revealed the following independent factors associated with good outcome: baseline National Institutes of Health Stroke Scale (NIHSS) <11 [odds ratio (OR), 13·64; 95% confidence interval (CI), 3·588-51·822; P = 0·0001],  glucose <150 mg/dl (OR, 3·76; 95%CI, 1·014-13·963; P = 0·0475), and early recanalization within 1 hour after t-PA infusion (OR, 5·28; 95%CI, 1·179-23·656; P = 0·0296). Those three variables  were selected for use in the good outcome scale, with NIHSS <11 as 2 points, glucose <150 mg/dl as 1 point, and early recanalization as 1 point. Frequencies of patients with good outcome for each score were as follows: score 0, 0·0%; score 1, 7·1%; score 2, 43·5%;  score 3, 65·4%; and score 4, 71·4%. The C statistic for the score was 0·849 (95%CI, 0·776-0·922).
  
  
  CONCLUSIONS
  A simple clinical and MRI scale can predict good outcome in t-PA patients.
authors.affiliation: Kawasaki Medical School, Kurashiki City, Okayama, Japan. kimurak@med.kawasaki-m.ac.jp
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Iguchi
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibazaki
authors.forename: Masao
authors.initials: M
authors.lastname: Watanabe
authors.forename: Junya
authors.initials: J
authors.lastname: Aoki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Junichi
authors.initials: J
authors.lastname: Uemura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator