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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointervention

Predicting Long-Term Outcome after Endovascular Stroke Treatment: The Totaled Health Risks in Vascular Events Score

A.C. Flint, S.P. Cullen, B.S. Faigeles and V.A. Rao
American Journal of Neuroradiology August 2010, 31 (7) 1192-1196; DOI: https://doi.org/10.3174/ajnr.A2050
A.C. Flint
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S.P. Cullen
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B.S. Faigeles
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V.A. Rao
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    Fig 1.

    Association of CDS with outcome. A progressively lower percentage of patients with good outcomes (mRS 0–2 at 90 days) is seen with each increased level of the CDS.

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    Fig 2.

    Association of the THRIVE score with outcome. A, Association of the 3 strata of the THRIVE score (0–2, 3–5, and 6–9) with good outcome (mRS 0–2 at 90 days). B, Association of the 3 strata of the THRIVE score (0–2, 3–5, and 6–9) with death by 90 days. C, Range of outcomes measured by the mRS at 90 days, according to the THRIVE score. For each of the 3 strata of the THRIVE score (0–2 versus 3–5 versus 6–9), the range of outcomes on the 90-day mRS is shown. Each increased level of the mRS is displayed by progressively darker gray-scale values, from white (mRS = 0) to black (mRS = 6). There were no patients with mRS = 5 in the THRIVE score 0–2 group.

Tables

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    Table 1:

    Association of chronic health conditions with outcomes after endovascular stroke treatmenta

    ConditionPoor Outcome (mRS 3–6)Good Outcome (mRS 0–2)Total (mRS 0–6)ORP ValueAdjusted ORb
    HTN77.4% (151/195)60.6% (57/94)72.0% (208/289)0.45<.010.56
    AFib46.6% (90/193)31.9% (30/94)41.8% (120/287)0.54.020.53
    DM23.8% (46/193)12.8% (12/94)20.2% (58/287)0.47.030.61
    CAD45.0% (85/189)34.0% (32/94)41.3% (117/283)0.63.10n/a
    CHF21.6% (41/190)14.9% (14/94)19.4% (55/284)0.64.20n/a
    Tob21.6% (39/181)23.9% (21/88)22.3% (60/269)1.14.76n/a
    Chol33.9% (59/174)35.2% (32/91)34.3% (91/265)1.06.89n/a
    • a Data are presented as percentages in each outcome category for a given diagnosis, followed by the number of patients with the diagnosis in this category over the total number of patients in this category.

    • b OR for good outcome in multivariable logistic regression, including the variables HTN, AFib, and DM.

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    Table 2:

    Multivariable logistic regression: association of age, NIHSS, recanalization, and CDS with good outcome

    VariableOR95% CIP Value
    Age0.9750.955–0.996.019
    NIHSS score0.8900.842–0.940<.001
    Recanalization19.737.61–51.23<.001
    CDS0.6650.456–0.970.034
    • View popup
    Table 3:

    Multivariable logistic regression: addition of chronic disease scale to age and NIHSS

    Model 1Pseudo-R2 = 0.0804; ROC AUC = 0.683Model 2Pseudo-R2 = 0.0928; ROC AUC = 0.709
    VariableORP ValueVariableORP Value
    Age (3 levels)a0.609.007Age (3 levels)0.724.097
    NIHSS (3 levels)b0.353<.001NIHSS (3 levels)b0.388<.001
    CDSc0.683.021
    • a Age trichotomized as shown in Table 4.

    • b NIHSS trichotomized as shown in Table 4.

    • c See Table 4.

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    Table 4:

    The totaled health risks in vascular events (THRIVE) score

    Points
    NIHSS
        ≤100
        11–202
        ≥214
    Age
        ≤590
        60–791
        ≥802
    CDS (1 point each for HTN, DM, AFib)
        00
        11
        22
        33
    THRIVE score = ___ (0–9)
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American Journal of Neuroradiology: 31 (7)
American Journal of Neuroradiology
Vol. 31, Issue 7
1 Aug 2010
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A.C. Flint, S.P. Cullen, B.S. Faigeles, V.A. Rao
Predicting Long-Term Outcome after Endovascular Stroke Treatment: The Totaled Health Risks in Vascular Events Score
American Journal of Neuroradiology Aug 2010, 31 (7) 1192-1196; DOI: 10.3174/ajnr.A2050

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Predicting Long-Term Outcome after Endovascular Stroke Treatment: The Totaled Health Risks in Vascular Events Score
A.C. Flint, S.P. Cullen, B.S. Faigeles, V.A. Rao
American Journal of Neuroradiology Aug 2010, 31 (7) 1192-1196; DOI: 10.3174/ajnr.A2050
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