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The ASTRAL score to predict functional outcome in acute ischemic stroke

The ASTRAL score to predict functional outcome in acute ischemic stroke. George Ntaios. University of Thessaly, Larissa, Greece. Let’s design the ideal prognostic score… not too many variables readily available variables simple to calculate applicable as early as possible

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The ASTRAL score to predict functional outcome in acute ischemic stroke

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  1. The ASTRAL score to predict functional outcome in acute ischemic stroke George Ntaios University of Thessaly, Larissa, Greece

  2. Let’s design the ideal • prognostic score… • not too many variables • readily available variables • simple to calculate • applicable as early as possible • widely-used scale for outcome assessment • validated externally • validated in large population • validated in multiple populations • Modified Rankin Scale score • Barthel index • Glasgow outcome scale • Oxford Handicap Scale

  3. ASTRAL registry (Lausanne/Switzerland) n=1645 Development of the prognostic score Prognostic point-based score Double external validation of the prognostic score Athens Stroke Registry n=1659 Vienna Stroke registry n=653 Color chart

  4. P=0.43

  5. ASTRAL registry (Lausanne/Switzerland) n=1645 Development of the prognostic score Prognostic point-based score Double external validation of the prognostic score Athens Stroke registry n=1659 Vienna Stroke registry n=653 Color chart

  6. P=0.22

  7. P=0.49

  8. P=0.82

  9. ASTRAL registry (Lausanne/Switzerland) n=1645 Development of the prognostic score Prognostic point-based score Double external validation of the prognostic score Athens Stroke Registry n=1659 Vienna Stroke Registry n=653 Color chart

  10. Take-home messages • the ASTRAL score is a very reliable prognostic score • it calculates the probability of poor outcome at three months • it can be used already at admission • it is very simple to use, especially with the help of the color chart

  11. Spare slides

  12. Oxford Handicap Scale score < 3 Stroke 2002; 33: 1041-1047

  13. logit(BI<95) = -5.782 + (0.049*age) + (0.272*NIHSS) Stroke 2004;35:158-162

  14. Stroke 2008;39;1821-1826

  15. ASTRAL score • - Validation in pooled Athens/Vienna dataset • Score by Weimar et al. • - Validation in the VISTA dataset Stroke 2008;39;1821-1826 Neurology 2012;78:1916–1922

  16. Stroke 2011;42:3421-3428

  17. Stroke 2011;42:3421-3428

  18. Stroke 2011;42:3421-3428

  19. P=0.43 P=0.22 P=0.82 P=0.49

  20. Predictors of long-term outcome

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