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

Research ArticleNeurointervention

Glasgow Coma Scale on Presentation Predicts Outcome in Endovascular Treatment for Acute Posterior Large-Vessel Occlusion

A.H. Chiu, D.A. Hince and W. McAuliffe
American Journal of Neuroradiology April 2020, 41 (4) 645-649; DOI: https://doi.org/10.3174/ajnr.A6497
A.H. Chiu
aFrom the Neurological Intervention and Imaging Service of Western Australia (A.H.C., W.M.), Western Australia Health, Sir Charles Gairdner, Royal Perth, and Fiona Stanley Hospitals, Perth, Australia
bMedical School, Division of Medicine (A.H.C., W.M.), University of Western Australia, Perth, Australia
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D.A. Hince
cInstitute for Health Research (D.A.H.), University of Notre Dame, Fremantle, Australia.
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W. McAuliffe
aFrom the Neurological Intervention and Imaging Service of Western Australia (A.H.C., W.M.), Western Australia Health, Sir Charles Gairdner, Royal Perth, and Fiona Stanley Hospitals, Perth, Australia
bMedical School, Division of Medicine (A.H.C., W.M.), University of Western Australia, Perth, Australia
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Article Figures & Data

Tables

    • View popup
    Table 1:

    Initial and final mTICI for the 73 patients with complete data

    CategoryNo. (%)
    Level of occlusion
     RVA, no LVA2
     RVA, small LVA1
     RVA, large LVA0
     LVA, no RVA0
     LVA, small RVA1
     LVA, large RVA0
     Bilateral VA1
     Lower basilar trunk22
     Upper basilar trunk9
     Basilar apex29
     RPCA2
     LPCA5
     Bilateral PCA1
    PC-ASPECTS
     1023
     98
     814
     710
     65
     52
     41
     31
     20
     10
     00
     No data9
    PcomA
     None30
     1, <1 mm9
     1, ≥1 mm4
     2, both <1 mm7
     2, 1 <1 mm; 1 ≥1 mm9
     2, both ≥1 mm12
     No data2
    I-mTICI
     066 (90.41)
     15 (6.85)
     2b1 (1.37)
     2c1 (1.37)
    F-mTICI
     06 (8.22)
     13 (4.11)
     2a1 (1.37)
     2b20 (27.40)
     2c7 (9.59)
     336 (49.32)
    F-mTICI ranges
     0–2a10 (13.70)
     2b–363 (86.30)
    • Note:—PcomA indicates posterior communicating artery; RVA, right vertebral artery; LVA, left vertebral artery; VA, vertebral artery; RPCA, right posterior cerebral artery; LPCA, left posterior cerebral artery; PCA, posterior cerebral artery.

    • View popup
    Table 2:

    Final documented causes for posterior circulatory occlusion in the 73 patients with complete data

    CauseNo. (%)
    Cardiogenic26 (35.62)
    Intracranial atheroma20 (27.40)
    Unknown9 (12.33)
    Dissection7 (9.59)
    Other NOS5 (6.85)
    Iatrogenic3 (4.11)
    Extracranial atheroma2 (2.74)
    Paradoxical1 (1.37)
    • Note:—NOS indicates not otherwise specified.

    • View popup
    Table 3:

    Univariable and multivariable odds ratios for the association between each predictor variable and binary mRS (where mRS >2 is the reference group)

    PredictorNo.Univariable OR95% CIPMultivariable ORa95% CIP
    Time to recanalization671.01–0.99–1.03.37
    GCS731.181.04–1.33.011.211.04–1.42.001
    IV-tPA
     No621.00
     Yes111.120.29–4.25.87
    Sex
     F261.00
     M471.280.46–3.55.64
    Age (yr)730.970.94–1.00.040.960.92–1.00.05
    PC-ASPECTS641.661.12–2.47.011.771.14–2.73.01
    • ↵a OR from the final model multivariable model (n = 64).

    • View popup
    Table 4:

    Univariable odds ratios, sensitivities, specificities, and area under ROC curves for the association between each predictor variable and binary mRS (where mRS >2 is the reference group)

    PredictorPositive GroupOR (95% CI)Sensitivity (95% CI)Specificity (95% CI)AUC (95% CI)
    GCSGCS > 135.70 (1.97–16.47)0.60 (0.39–0.79)0.79 (0.65–0.90)0.70 (0.58–0.81)
    PC-ASPECTS>94.03 (1.36–11.98)0.57 (0.35–0.77)0.76 (0.60–0.88)0.66 (0.54–0.78)
    Age (yr)<68.51.50 (0.56–4.07)a0.64 (0.43–0.82)0.46 (0.31–0.61)0.55 (0.43–0.69)
    Multivariable modelPr  <0.3211.48 (3.22–40.91)0.83 (0.61–0.95)0.71 (0.55–0.84)0.77 (0.55–0.84)
    • Note:—AUC indicates area under the curve; Pr, predicted probability from the model; ROC, receiver operating characteristic.

    • ↵a Not significant.

    • View popup
    Table 5:

    Cross-tabulation and χ2 analyses for the association between mRS (0–2 vs 3–6) and binary mTICI measures in the 73 patients with complete data

    mRSP1
    0–23–6
    F-mTICI
     0–2a010
     2b–32538.01
    I-mTICI
     0-2a2447
     2b–311.63
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American Journal of Neuroradiology: 41 (4)
American Journal of Neuroradiology
Vol. 41, Issue 4
1 Apr 2020
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Cite this article
A.H. Chiu, D.A. Hince, W. McAuliffe
Glasgow Coma Scale on Presentation Predicts Outcome in Endovascular Treatment for Acute Posterior Large-Vessel Occlusion
American Journal of Neuroradiology Apr 2020, 41 (4) 645-649; DOI: 10.3174/ajnr.A6497

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Glasgow Coma Scale on Presentation Predicts Outcome in Endovascular Treatment for Acute Posterior Large-Vessel Occlusion
A.H. Chiu, D.A. Hince, W. McAuliffe
American Journal of Neuroradiology Apr 2020, 41 (4) 645-649; DOI: 10.3174/ajnr.A6497
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