Abstract Details

Title The HIAT2 Score Is Superior to CT Perfusion in Predicting Outcomes in Anterior Circulation Stroke Patients Evaluated for Interventional Therapy

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 254

Objective

Background BACKGROUND: There are different approaches to triage stroke patients who might benefit from endovascular therapy. Some rely on advanced imaging modalities like CTP and others use clinical and radiological parameters like HIAT2 score (0 to 10) which scores for age (?59=0, 60-79=2, ?80 years=4), Glucose (<150=0, ?150=1), NIHSS (?10=0), 11-20=1, ?21=2), and ASPECTS (8-10=0, ?7=3). While HIAT2 was proven to be superior to other scores in predicting outcome, it has not been compared to advanced neuroimaging.

Design/Methods DESIGN/METHODS: We reviewed records of patients with large vessel anterior circulation strokes evaluated for neurointerventional treatment between August 2010 and September 2012. Patients underwent CTP, head CT, and head and neck CTA as part of our protocol. Two examiners calculated ASPECTS. Favorable CT perfusion was defined as core infarct size <1/3rd MCA distribution and penumbra >20% of infarct size. mRS was determined by telephone interview at 3 months or before for patients after July 2012. Patients were divided into two groups: good outcome (mRS<4) and poor outcome (mRS?4) which were compared for clinical, laboratory, time, radiological parameters, and neurointerventional therapy. Unfavorable HIAT2 score was ?5 as defined in the literature. Analysis was done using Fisher's test and multivariate logistic regression.

Results RESULTS: We identified 60 patients with anterior circulation large vessel occlusion; 65% had poor outcome. Patients with poor outcome were more likely to have NIHSS >20 (67% vs. 29%,p=0.007), blood glucose ?150 (45% vs. 10%,p=0.008), and HIAT2 ?5 (74% vs. 29%,p=0.001). The percentage of patients with favorable CTP was similar between both groups (38% vs. 57%,p=0.186). On regression analysis, HIAT2 ?5 was the only independent predictor of poor outcome (OR=3.8,CI:1.1-14.3,p=0.046).

Conclusions CONCLUSIONS: HIAT2 score better predicts outcomes of stroke patients evaluated for interventional therapy than CTP.

Authors/Disclosures
Shadi Yaghi, MD (Hackensack Meridian Health) PRESENTER	Dr. Yaghi has nothing to disclose.
Nicolas A. Bianchi, MD (Emory University)	Dr. Bianchi has received personal compensation in the range of $0-$499 for serving as a Consultant for Innovation Hub Enterprises, LLC. The institution of Dr. Bianchi has received research support from Emory Medical Care Foundation.
	No disclosure on file
Archana Hinduja, MD	Dr. Hinduja has nothing to disclose.
	No disclosure on file

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