External Validation of the Boston Acute Stroke Imaging Scale and M1-BASIS in Thrombolyzed Patients
BACKGROUND AND PURPOSE—Radiological findings play an essential role in therapeutic decision making and prognostication in acute ischemic stroke (AIS). The Boston Acute Stroke Imaging Scale (BASIS) and Middle Cerebral Artery-BASIS (M1-BASIS) methodologies are rapid purely radiological instruments and...
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| Veröffentlicht in: | Stroke (1970) 2014-10, Vol.45 (10), p.2942-2947 |
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| creator | Yeo, Leonard L.L Paliwal, Prakash R Wakerley, Benjamin Khoo, Chin M Teoh, Hock L Ahmad, Aftab Ting, Eric Y Seet, Raymond C Ong, Venetia Chan, Bernard P Yohanna, Kusama Gopinathan, Anil Rathakrishnan, Rahul Sharma, Vijay K |
| description | BACKGROUND AND PURPOSE—Radiological findings play an essential role in therapeutic decision making and prognostication in acute ischemic stroke (AIS). The Boston Acute Stroke Imaging Scale (BASIS) and Middle Cerebral Artery-BASIS (M1-BASIS) methodologies are rapid purely radiological instruments and easily applicable for patients with AIS. We validated these methods in patients with AIS treated with intravenous tissue-type plasminogen activator.
METHODS—For BASIS, patients were labeled as having major stroke if there was occlusion of distal internal carotid artery, proximal (both M1 and M2 segments) of middle cerebral artery or the basilar artery, or an Alberta Stroke Program Early CT Score ≤7. M1-BASIS differs from BASIS by classifying AIS patients with M2 occlusion as a minor stroke. We evaluated these classification systems for predicting functional outcomes (modified Rankin Scale score 0–1) at 3 months.
RESULTS—Two hundred sixty-five consecutive AIS patients treated with intravenous tissue-type plasminogen activator were included. On multivariate analysis, younger age (odds ratio, 1.039, 95% confidence interval, 1.009–1.070; P=0.011), lower National Institutes of Health Stroke Scale score (odds ratio, 1.140; 95% confidence interval, 1.073–1.210; P |
| doi_str_mv | 10.1161/STROKEAHA.114.006776 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1161_STROKEAHA_114_006776</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>25169951</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4266-a68904676d73cd6a7182243af6159d6597bd7300bf62bde53b31e2fd8f2e83813</originalsourceid><addsrcrecordid>eNp9kNFOwjAYhRujEUTfwJi-wLDtum69HASFiME49Hbp1o5NupV0JYhP78yUS6_-fPnPORcfALcYjTFm-D5Zv66eZvE87pCOEWJhyM7AEAeEepSR6BwMEfK5RyjnA3DVth8IIeJHwSUYkAAzzgM8BNns0ynbCA3fha6kcJVpoCmgKxWcmNZ1FOd7p2DirNkquKjFpmo2MMmFVlA0Ej5jbxIniwRWDVyX1tSZ0ccvJeFLN6Ya116Di0LoVt383hF4e5itp3NvuXpcTOOll1PCmCdYxBFlIZOhn0smQhwRQn1RMBxwyQIeZt0HoaxgJJMq8DMfK1LIqCAq8iPsjwDtd3Nr2taqIt3Zqhb2mGKU_ihLT8o6pGmvrKvd9bXdPquVPJX-HHWBqA8cjO5ctVu9PyiblkpoV_6__Q3SH3kb</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>External Validation of the Boston Acute Stroke Imaging Scale and M1-BASIS in Thrombolyzed Patients</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><source>Journals@Ovid Complete</source><creator>Yeo, Leonard L.L ; Paliwal, Prakash R ; Wakerley, Benjamin ; Khoo, Chin M ; Teoh, Hock L ; Ahmad, Aftab ; Ting, Eric Y ; Seet, Raymond C ; Ong, Venetia ; Chan, Bernard P ; Yohanna, Kusama ; Gopinathan, Anil ; Rathakrishnan, Rahul ; Sharma, Vijay K</creator><creatorcontrib>Yeo, Leonard L.L ; Paliwal, Prakash R ; Wakerley, Benjamin ; Khoo, Chin M ; Teoh, Hock L ; Ahmad, Aftab ; Ting, Eric Y ; Seet, Raymond C ; Ong, Venetia ; Chan, Bernard P ; Yohanna, Kusama ; Gopinathan, Anil ; Rathakrishnan, Rahul ; Sharma, Vijay K</creatorcontrib><description>BACKGROUND AND PURPOSE—Radiological findings play an essential role in therapeutic decision making and prognostication in acute ischemic stroke (AIS). The Boston Acute Stroke Imaging Scale (BASIS) and Middle Cerebral Artery-BASIS (M1-BASIS) methodologies are rapid purely radiological instruments and easily applicable for patients with AIS. We validated these methods in patients with AIS treated with intravenous tissue-type plasminogen activator.
METHODS—For BASIS, patients were labeled as having major stroke if there was occlusion of distal internal carotid artery, proximal (both M1 and M2 segments) of middle cerebral artery or the basilar artery, or an Alberta Stroke Program Early CT Score ≤7. M1-BASIS differs from BASIS by classifying AIS patients with M2 occlusion as a minor stroke. We evaluated these classification systems for predicting functional outcomes (modified Rankin Scale score 0–1) at 3 months.
RESULTS—Two hundred sixty-five consecutive AIS patients treated with intravenous tissue-type plasminogen activator were included. On multivariate analysis, younger age (odds ratio, 1.039, 95% confidence interval, 1.009–1.070; P=0.011), lower National Institutes of Health Stroke Scale score (odds ratio, 1.140; 95% confidence interval, 1.073–1.210; P<0.001), and minor stroke by M1-BASIS (odds ratio, 2.376; 95% confidence interval, 1.047–5.393; P=0.039) were independent predictors of good functional outcome. When compared with National Institutes of Health Stroke Scale, the receiver operating characteristic curves for both BASIS (area under the curve, 0.721) and M1-BASIS (area under the curve, 0.795) correlated well with clinical severity scores. M1-BASIS has an additive effect with the National Institutes of Health Stroke Scale score to predict good outcomes.
CONCLUSIONS—The purely radiological M1-BASIS correlates well with the clinical severity of stroke and can be a reliable prognostication tool in thrombolyzed AIS patients. This system might find an important place in the current era of telestroke.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.114.006776</identifier><identifier>PMID: 25169951</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Cerebral Angiography ; Female ; Fibrinolytic Agents - therapeutic use ; Humans ; Image Interpretation, Computer-Assisted ; Male ; Middle Aged ; Prognosis ; Recovery of Function ; ROC Curve ; Stroke - classification ; Stroke - diagnostic imaging ; Stroke - drug therapy ; Thrombolytic Therapy ; Tissue Plasminogen Activator - therapeutic use ; Tomography, X-Ray Computed</subject><ispartof>Stroke (1970), 2014-10, Vol.45 (10), p.2942-2947</ispartof><rights>2014 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4266-a68904676d73cd6a7182243af6159d6597bd7300bf62bde53b31e2fd8f2e83813</citedby><cites>FETCH-LOGICAL-c4266-a68904676d73cd6a7182243af6159d6597bd7300bf62bde53b31e2fd8f2e83813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25169951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yeo, Leonard L.L</creatorcontrib><creatorcontrib>Paliwal, Prakash R</creatorcontrib><creatorcontrib>Wakerley, Benjamin</creatorcontrib><creatorcontrib>Khoo, Chin M</creatorcontrib><creatorcontrib>Teoh, Hock L</creatorcontrib><creatorcontrib>Ahmad, Aftab</creatorcontrib><creatorcontrib>Ting, Eric Y</creatorcontrib><creatorcontrib>Seet, Raymond C</creatorcontrib><creatorcontrib>Ong, Venetia</creatorcontrib><creatorcontrib>Chan, Bernard P</creatorcontrib><creatorcontrib>Yohanna, Kusama</creatorcontrib><creatorcontrib>Gopinathan, Anil</creatorcontrib><creatorcontrib>Rathakrishnan, Rahul</creatorcontrib><creatorcontrib>Sharma, Vijay K</creatorcontrib><title>External Validation of the Boston Acute Stroke Imaging Scale and M1-BASIS in Thrombolyzed Patients</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>BACKGROUND AND PURPOSE—Radiological findings play an essential role in therapeutic decision making and prognostication in acute ischemic stroke (AIS). The Boston Acute Stroke Imaging Scale (BASIS) and Middle Cerebral Artery-BASIS (M1-BASIS) methodologies are rapid purely radiological instruments and easily applicable for patients with AIS. We validated these methods in patients with AIS treated with intravenous tissue-type plasminogen activator.
METHODS—For BASIS, patients were labeled as having major stroke if there was occlusion of distal internal carotid artery, proximal (both M1 and M2 segments) of middle cerebral artery or the basilar artery, or an Alberta Stroke Program Early CT Score ≤7. M1-BASIS differs from BASIS by classifying AIS patients with M2 occlusion as a minor stroke. We evaluated these classification systems for predicting functional outcomes (modified Rankin Scale score 0–1) at 3 months.
RESULTS—Two hundred sixty-five consecutive AIS patients treated with intravenous tissue-type plasminogen activator were included. On multivariate analysis, younger age (odds ratio, 1.039, 95% confidence interval, 1.009–1.070; P=0.011), lower National Institutes of Health Stroke Scale score (odds ratio, 1.140; 95% confidence interval, 1.073–1.210; P<0.001), and minor stroke by M1-BASIS (odds ratio, 2.376; 95% confidence interval, 1.047–5.393; P=0.039) were independent predictors of good functional outcome. When compared with National Institutes of Health Stroke Scale, the receiver operating characteristic curves for both BASIS (area under the curve, 0.721) and M1-BASIS (area under the curve, 0.795) correlated well with clinical severity scores. M1-BASIS has an additive effect with the National Institutes of Health Stroke Scale score to predict good outcomes.
CONCLUSIONS—The purely radiological M1-BASIS correlates well with the clinical severity of stroke and can be a reliable prognostication tool in thrombolyzed AIS patients. This system might find an important place in the current era of telestroke.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Area Under Curve</subject><subject>Cerebral Angiography</subject><subject>Female</subject><subject>Fibrinolytic Agents - therapeutic use</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Recovery of Function</subject><subject>ROC Curve</subject><subject>Stroke - classification</subject><subject>Stroke - diagnostic imaging</subject><subject>Stroke - drug therapy</subject><subject>Thrombolytic Therapy</subject><subject>Tissue Plasminogen Activator - therapeutic use</subject><subject>Tomography, X-Ray Computed</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kNFOwjAYhRujEUTfwJi-wLDtum69HASFiME49Hbp1o5NupV0JYhP78yUS6_-fPnPORcfALcYjTFm-D5Zv66eZvE87pCOEWJhyM7AEAeEepSR6BwMEfK5RyjnA3DVth8IIeJHwSUYkAAzzgM8BNns0ynbCA3fha6kcJVpoCmgKxWcmNZ1FOd7p2DirNkquKjFpmo2MMmFVlA0Ej5jbxIniwRWDVyX1tSZ0ccvJeFLN6Ya116Di0LoVt383hF4e5itp3NvuXpcTOOll1PCmCdYxBFlIZOhn0smQhwRQn1RMBxwyQIeZt0HoaxgJJMq8DMfK1LIqCAq8iPsjwDtd3Nr2taqIt3Zqhb2mGKU_ihLT8o6pGmvrKvd9bXdPquVPJX-HHWBqA8cjO5ctVu9PyiblkpoV_6__Q3SH3kb</recordid><startdate>201410</startdate><enddate>201410</enddate><creator>Yeo, Leonard L.L</creator><creator>Paliwal, Prakash R</creator><creator>Wakerley, Benjamin</creator><creator>Khoo, Chin M</creator><creator>Teoh, Hock L</creator><creator>Ahmad, Aftab</creator><creator>Ting, Eric Y</creator><creator>Seet, Raymond C</creator><creator>Ong, Venetia</creator><creator>Chan, Bernard P</creator><creator>Yohanna, Kusama</creator><creator>Gopinathan, Anil</creator><creator>Rathakrishnan, Rahul</creator><creator>Sharma, Vijay K</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201410</creationdate><title>External Validation of the Boston Acute Stroke Imaging Scale and M1-BASIS in Thrombolyzed Patients</title><author>Yeo, Leonard L.L ; Paliwal, Prakash R ; Wakerley, Benjamin ; Khoo, Chin M ; Teoh, Hock L ; Ahmad, Aftab ; Ting, Eric Y ; Seet, Raymond C ; Ong, Venetia ; Chan, Bernard P ; Yohanna, Kusama ; Gopinathan, Anil ; Rathakrishnan, Rahul ; Sharma, Vijay K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4266-a68904676d73cd6a7182243af6159d6597bd7300bf62bde53b31e2fd8f2e83813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Area Under Curve</topic><topic>Cerebral Angiography</topic><topic>Female</topic><topic>Fibrinolytic Agents - therapeutic use</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Recovery of Function</topic><topic>ROC Curve</topic><topic>Stroke - classification</topic><topic>Stroke - diagnostic imaging</topic><topic>Stroke - drug therapy</topic><topic>Thrombolytic Therapy</topic><topic>Tissue Plasminogen Activator - therapeutic use</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yeo, Leonard L.L</creatorcontrib><creatorcontrib>Paliwal, Prakash R</creatorcontrib><creatorcontrib>Wakerley, Benjamin</creatorcontrib><creatorcontrib>Khoo, Chin M</creatorcontrib><creatorcontrib>Teoh, Hock L</creatorcontrib><creatorcontrib>Ahmad, Aftab</creatorcontrib><creatorcontrib>Ting, Eric Y</creatorcontrib><creatorcontrib>Seet, Raymond C</creatorcontrib><creatorcontrib>Ong, Venetia</creatorcontrib><creatorcontrib>Chan, Bernard P</creatorcontrib><creatorcontrib>Yohanna, Kusama</creatorcontrib><creatorcontrib>Gopinathan, Anil</creatorcontrib><creatorcontrib>Rathakrishnan, Rahul</creatorcontrib><creatorcontrib>Sharma, Vijay K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yeo, Leonard L.L</au><au>Paliwal, Prakash R</au><au>Wakerley, Benjamin</au><au>Khoo, Chin M</au><au>Teoh, Hock L</au><au>Ahmad, Aftab</au><au>Ting, Eric Y</au><au>Seet, Raymond C</au><au>Ong, Venetia</au><au>Chan, Bernard P</au><au>Yohanna, Kusama</au><au>Gopinathan, Anil</au><au>Rathakrishnan, Rahul</au><au>Sharma, Vijay K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>External Validation of the Boston Acute Stroke Imaging Scale and M1-BASIS in Thrombolyzed Patients</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2014-10</date><risdate>2014</risdate><volume>45</volume><issue>10</issue><spage>2942</spage><epage>2947</epage><pages>2942-2947</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><abstract>BACKGROUND AND PURPOSE—Radiological findings play an essential role in therapeutic decision making and prognostication in acute ischemic stroke (AIS). The Boston Acute Stroke Imaging Scale (BASIS) and Middle Cerebral Artery-BASIS (M1-BASIS) methodologies are rapid purely radiological instruments and easily applicable for patients with AIS. We validated these methods in patients with AIS treated with intravenous tissue-type plasminogen activator.
METHODS—For BASIS, patients were labeled as having major stroke if there was occlusion of distal internal carotid artery, proximal (both M1 and M2 segments) of middle cerebral artery or the basilar artery, or an Alberta Stroke Program Early CT Score ≤7. M1-BASIS differs from BASIS by classifying AIS patients with M2 occlusion as a minor stroke. We evaluated these classification systems for predicting functional outcomes (modified Rankin Scale score 0–1) at 3 months.
RESULTS—Two hundred sixty-five consecutive AIS patients treated with intravenous tissue-type plasminogen activator were included. On multivariate analysis, younger age (odds ratio, 1.039, 95% confidence interval, 1.009–1.070; P=0.011), lower National Institutes of Health Stroke Scale score (odds ratio, 1.140; 95% confidence interval, 1.073–1.210; P<0.001), and minor stroke by M1-BASIS (odds ratio, 2.376; 95% confidence interval, 1.047–5.393; P=0.039) were independent predictors of good functional outcome. When compared with National Institutes of Health Stroke Scale, the receiver operating characteristic curves for both BASIS (area under the curve, 0.721) and M1-BASIS (area under the curve, 0.795) correlated well with clinical severity scores. M1-BASIS has an additive effect with the National Institutes of Health Stroke Scale score to predict good outcomes.
CONCLUSIONS—The purely radiological M1-BASIS correlates well with the clinical severity of stroke and can be a reliable prognostication tool in thrombolyzed AIS patients. This system might find an important place in the current era of telestroke.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>25169951</pmid><doi>10.1161/STROKEAHA.114.006776</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Adult Aged Aged, 80 and over Area Under Curve Cerebral Angiography Female Fibrinolytic Agents - therapeutic use Humans Image Interpretation, Computer-Assisted Male Middle Aged Prognosis Recovery of Function ROC Curve Stroke - classification Stroke - diagnostic imaging Stroke - drug therapy Thrombolytic Therapy Tissue Plasminogen Activator - therapeutic use Tomography, X-Ray Computed |
| title | External Validation of the Boston Acute Stroke Imaging Scale and M1-BASIS in Thrombolyzed Patients |
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