title: Applicability of the SPAN-100 index in a prospective and contemporary cohort of patients treated with intravenous rtPA in Catalonia.
abstract: BACKGROUND
  Prognostic scales can be helpful for selecting patients for reperfusion treatment. This study aims to assess the prognostic ability of the recently published SPAN-100 index in a large cohort of stroke patients treated with intravenous thrombolysis (IV rtPA).
  
  
  METHODS
  Using data from the prospective registery of all reperfusion treatments administered in Catalonia, we selected patients treated with IV rtPA alone between 2011 and 2012. The SPAN-100 index was calculated as the sum of age (years) and NIHSS score, and patients in the cohort were classified as SPAN-100 positive [≥ 100] or SPAN-100 negative [< 100]. We measured raw and adjusted rates of symptomatic intracerebral haemorrhage (SICH), mortality, and 3-month functional outcome (mRS 0-2) for each SPAN-100 category. Area under the ROC curve was calculated to predict the main outcome measures.
  
  
  RESULTS
  We studied 1685 rtPA-treated patients, of whom 1405 (83%) were SPAN-100 negative. The SICH rates adjusted for sex, pre-stroke mRS, hypertension, diabetes, dyslipidaemia, ischaemic heart disease, heart failure, atrial fibrillation, prior TIA/stroke and time to thrombolysis did not differ between groups, but likelihood of functional independence (mRS 0-2) at 3 months was nearly 8 times higher in the SPAN-100 negative group than in the positive group. Furthermore, the 3-month mortality rate was 5 times higher in the SPAN-100 positive group. ROC curve analysis showed high specificities for predicting both functional independence and 3-month mortality for a cut-off point of 100.
  
  
  CONCLUSIONS
  The SPAN-100 index is a simple and straightforward method that may be useful for selecting candidates for rtPA treatment in doubtful cases, and for informing patients and their relatives about likely outcomes.
authors.affiliation: Plan Director de Enfermedades Cerebrovasculares, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España. Electronic address: sabilleira@gencat.cat.
authors.forename: S
authors.initials: S
authors.lastname: Abilleira
authors.affiliation: Unidad de Epidemiología Cardiovascular, Servicio de Cardiología, Hospital Vall d'Hebrón , Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Ribera
authors.affiliation: Servicio de Neurología, Hospital de Bellvitge, l'Hospitalet de Llobregat, Barcelona, España.
authors.forename: H
authors.initials: H
authors.lastname: Quesada
authors.affiliation: Servicio de Neurología, Hospital Vall d'Hebrón, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Rubiera
authors.affiliation: Servicio de Neurología, Hospital Josep Trueta, Girona, España.
authors.forename: M
authors.initials: M
authors.lastname: Castellanos
authors.affiliation: Servicio de Neurología, Hospital Clínic, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Vargas
authors.affiliation: Servicio de Neurología, Hospital Germans Trias, Badalona, España.
authors.forename: M
authors.initials: M
authors.lastname: Gomis
authors.affiliation: Servicio de Neurología, Hospital Mútua de Terrassa, Terrassa, España.
authors.forename: J
authors.initials: J
authors.lastname: Krupinski
authors.affiliation: Servicio de Neurología, Hospital de Sant Pau, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Delgado-Mederos
authors.affiliation: Servicio de Neurología, Hospital Moisès Broggi, Sant Joan Despí, España.
authors.forename: M
authors.initials: M
authors.lastname: Gómez-Choco
authors.affiliation: Servicio de Neurología, Hospital del Mar, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Giralt-Steinhauer
authors.affiliation: Servicio de Neurología, Hospital Parc Taulí, Sabadell, España.
authors.forename: M C
authors.initials: MC
authors.lastname: Garcia
authors.affiliation: Servicio de Neurología, Hospital Joan XXIII, Tarragona, España.
authors.forename: A
authors.initials: A
authors.lastname: Pellisé
authors.affiliation: Servicio de Neurología, Hospital Arnau de Vilanova, Lleida, España.
authors.forename: F
authors.initials: F
authors.lastname: Purroy
authors.affiliation: Servicio de Neurología, Hospital Verge de la Cinta, Tortosa, España.
authors.forename: M
authors.initials: M
authors.lastname: Garcés
authors.affiliation: Plan Director de Enfermedades Cerebrovasculares, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Gallofré
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D013030:Spain; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Functional independence; Ictus; Independencia funcional; Mortalidad; Mortality; Predicción de riesgo; Prognosis; Pronóstico; Risk prediction; Stroke; Thrombolysis; Trombólisis