Comparison of risk models in predicting intracranial hemorrhage and poor outcomes in acute anterior circulation ischemic stroke after mechanical thrombectomy / 中国脑血管病杂志

ABSTRACT

Objective To compare the efficacies of 4 risk models (THRIVE[Totaled Health Risks in Vascular Events],MSS[Multicenter Stroke Survey],HIAT[Houston Intra-Arterial Therapy],and GRASPS[Glucose at presentation,Race,Age,Sex,Systolic blood pressure,Severity of stroke at presentation]) in predicting intracranial hemorrhage and poor outcomes in acute anterior circulation ischemic stroke after mechanical thrombectomy.Methods From May 2013 to March 2016,153 consecutive patients with acute anterior circulation vascular occlusion conducted mechanical thrombectomy within 6 hours after onset and admitted to the Departments of Neurology,Jinling Hospital,Nanjing University School of Medicine and Zhongshan Hospital,Xiamen University were enrolled prospectively.Logistic regression analysis and the area under the receiver operating characteristic (ROC) curve (AUC) were used to investigate the efficacies of 4 risk models (the THRIVE,MSS,HIAT,and GRASPS scores) for predicting intracerebral hemorrhage (including any intracranial hemorrhage events and symptomatic intracranial hemorrhage) and poor outcomes (including 90 d all-cause death and modified Rankin Scale[mRS] score≥3) in acute anterior circulation ischemic stroke after mechanical thrombectomy.Results The MSS score (AUC 0.639,95%CI 0.548-0.730,P=0.004) and GRASPS score (AUC 0.616,95%CI 0.525-0.706,P=0.017) could predict any intracranial hemorrhage events,but the predictive accuracy was low.They had the predictive value for death within 90 d after mechanical thrombectomy,and the GRASPS score (AUC 0.783,95%CI 0.706-0.860,P0.7.The AUC of GRASPS score was the largest (AUC 0.782,95%CI 0.708-0.885,P<0.01).Both had moderate predictive accuracy.Conclusion The GRASPS score had a better clinical predictive value for all-cause death and poor prognosis within 90 d after mechanical thrombectomy.The THRIVE score had a better clinical predictive value for poor prognosis at 90 d.The 4 models predictive value for intracranial hemorrhage events after mechanical thrombectomy should be further examined.