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

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Presentation on theme: "The ASTRAL score to predict functional outcome in acute ischemic stroke University of Thessaly, Larissa, Greece George Ntaios."— Presentation transcript:

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

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3 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

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

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9 P=0.43

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

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13 P=0.22

14 P=0.49

15 P=0.82

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

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21 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

22 Spare slides

23 Stroke 2002; 33: Oxford Handicap Scale score < 3

24 logit(BI<95) = (0.049*age) + (0.272*NIHSS) Stroke 2004;35:

25 Stroke 2008;39;

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

27 Stroke 2011;42:

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33 P=0.43 P=0.22 P=0.49 P=0.82

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36 5-year unfavourable outcome (mRS=3-6) 5-year mortality ASTRAL score (per 1 point increase) 1.09 (1.08 – 1.10) * Atrial fibrillation1.53 (1.14 – 2.04) † Heart Failure1.56 (1.14 – 2.13) † Stroke subtypes11 Lacunar1.71 (1.10 – 2.66) ‡ 1.14 (0.67 – 1.94) Atherosclerotic1.65 (1.03 – 2.63) ‡ 1.74 (1.02 – 2.97) ‡ Cardioembolic2.82 (1.84 – 4.34) * 2.39 (1.46 – 3.93) * Undetermined0.74 (0.58 – 0.95) ‡ Predictors of long-term outcome


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