CT interpretation by ASPECTS in hyperacute ischemic stroke predicting functional outcomes

Jpn J Radiol. 2013 Oct;31(10):701-5. doi: 10.1007/s11604-013-0240-6. Epub 2013 Sep 5.

Abstract

Purpose: To determine whether the Alberta Stroke Program Early CT Scores (ASPECTS) can predict posttreatment functional outcomes in hyperacute stroke patients who receive recombinant tissue-type plasminogen activator (rt-PA) treatment within 4.5 h.

Materials and methods: We studied 162 patients treated with rt-PA within 4.5 h of clinical onset. Of those, 29 patients (17.90 %) received rt-PA treatment between 3 and 4.5 h. Systematic CT scoring with the ASPECTS method was done. The primary outcome was the correlations between ASPECTS and the functional status at 3 months follow-up using the modified Rankin Scale.

Results: Clinical variables between those who received rt-PA treatment before and after 3 h were mostly comparable except the proportion of male gender. There were 116 patients (71.60 %) who were classified as independent. Time to receive CT scan or rt-PA treatment was not significantly associated with patients' functional status. Baseline NIHSS and ASPECTS scores were significant factors associated with dependent status or death at 3 months after rt-PA treatment. The adjusted odds ratios were 1.133 [95 % confidence interval (CI), 1.047-1.226] and 0.844 (95 % CI, 0.720-0.990), respectively.

Conclusion: The ASPECTS predicts the functional status of acute stroke patients who received rt-PA treatment within the 4.5-h golden period.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Ischemia / diagnostic imaging*
  • Brain Ischemia / drug therapy*
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Recovery of Function
  • Retrospective Studies
  • Stroke / diagnostic imaging*
  • Stroke / drug therapy*
  • Time Factors
  • Tissue Plasminogen Activator / therapeutic use*
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator