Comparison of Regional Lepomeningeal Collateral Score and Tan Collateral Score in prediction of prognosis of anterior ischemic stroke with intravenous thrombolysis

Abstract

Objective To screen the related influencing factors of prognosis in acute anterior ischemic stroke patients who underwent intravenous thrombolysis, and to explore the predictive ability of two collateral scores based on CT angiography (CTA).  Methods A total of 136 patients with acute ischemic stroke were treated by recombinant tissue-type plasminogen activator (rt-PA) intravenous thrombolysis. Regional Lepomeningeal Collateral Score (rLMC) and Tan Collateral Score (Tan) based on CTA were used to assess the collateral status. Modified Rankin Scale (mRS) was used to evaluate the prognosis (death or disability as main outcome indicators) 3 months after onset. Univariate and multivariate stepwise Logistic regression analysis was used to screen related risk factors for poor prognosis of intravenous thrombolysis in acute anterior ischemic stroke. Receiver operating characteristic (ROC) curve was used to evaluate predictive ability of Tan score on the prognosis of intravenous thrombolysis in acute anterior ischemic stroke.  Results Among 136 cases, 122 patients with acute anterior ischemic stroke who underwent rt-PA intravenous thrombolysis were finally included. Logistic regression analysis showed time from onset to intravenous thrombolysis (180-270 min; OR = 0.309, 95%CI: 0.134-0.713, P = 0.006) and Tan (0-1 score; OR = 7.339, 95%CI: 2.072-25.994, P = 0.002) was independent risk factors for poor prognosis of intravenous thrombolysis in acute anterior ischemic stroke. ROC curve of Tan score predicting the prognosis of intravenous thrombolysis in acute anterior ischemic stroke indicated that area under the curve (AUC) was 0.753 (P = 0.021).  Conclusions Time from onset to intravenous thrombolysis (180-270 min) and Tan score (0-1 score) are independent risk factors for poor prognosis of intravenous thrombolysis in acute anterior ischemic stroke. Compared with rLMC score, Tan score is a simple and reliable collateral status evaluation system.

DOI: 10.3969/j.issn.1672-6731.2018.09.010