The iScore predicts clinical response to tissue plasminogen activator in korean stroke patients

Tai Hwan Park, Sang Soon Park, Youngchai Ko, Soo Joo Lee, Kyung Bok Lee, Jun Lee, Kyusik Kang, Jong Moo Park, Jay Chol Choi, Dong Eog Kim, Yong Jin Cho, Keun Sik Hong, Joon Tae Kim, Dae Hyun Kim, Jae Kwan Cha, Moon Ku Han, Ji Sung Lee, Juneyoung Lee, Kyung Ho Yu, Byung Chul LeeByung Woo Yoon, Hee Joon Bae, Gustavo Saposnik

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Despite substantial differences in clinical features between Asian and Western stroke patients, there are no published prognostic tools validated in an Asiatic population for thrombolytic therapy. We assessed the ability of the iScore to predict the clinical response after intravenous thrombolysis with tissue plasminogen activator (tPA) in a Korean stroke population. Methods We applied the iScore to eligible participants in the nationwide multicenter stroke registry in Korea. Main outcome measures were poor functional outcome defined as having a modified Rankin Scale score 3-6 and death at 3 months. Symptomatic intracranial hemorrhage (sICH) was evaluated as a safety outcome. C statistic was calculated to assess performance of iScore. Results Among 4760 patients with an acute ischemic stroke, 622 (13.1%) received tPA, 548 patients had complete information for the analysis. C statistics for poor functional outcome and death at 3 months were.813 (95% confidence interval [CI]:.778-.848) and.820 (95% CI:.769-.872), respectively. Overall, there was a high correlation between observed and expected outcome for poor functional outcome (Pearson correlation coefficient, r =.982) and for death at 3 months (r =.950) at the risk score level. An iScore of 180 or more was associated with a more than 2 times risk of poor functional outcome and about 6 times risk of death at 3 months. There was an interaction between the iScore and tPA for a poor functional outcome (P value for the interaction <.001). We found a gradient effect in the incident risk of sICH with the iScore. Conclusion The iScore reliably predicts stroke outcomes after tPA in Asiatic population.

Original languageEnglish
Pages (from-to)367-373
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume23
Issue number2
DOIs
Publication statusPublished - 2014 Feb

Keywords

  • Risk score
  • ischemic stroke
  • prediction
  • thrombolysis

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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    Park, T. H., Park, S. S., Ko, Y., Lee, S. J., Lee, K. B., Lee, J., Kang, K., Park, J. M., Choi, J. C., Kim, D. E., Cho, Y. J., Hong, K. S., Kim, J. T., Kim, D. H., Cha, J. K., Han, M. K., Lee, J. S., Lee, J., Yu, K. H., ... Saposnik, G. (2014). The iScore predicts clinical response to tissue plasminogen activator in korean stroke patients. Journal of Stroke and Cerebrovascular Diseases, 23(2), 367-373. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.05.025