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Clinical prediction of thrombectomy eligibility: A systematic review and 4-item decision tree.


ABSTRACT: BACKGROUND:A clinical large anterior vessel occlusion (LAVO)-prediction scale could reduce treatment delays by allocating intra-arterial thrombectomy (IAT)-eligible patients directly to a comprehensive stroke center. AIM:To subtract, validate and compare existing LAVO-prediction scales, and develop a straightforward decision support tool to assess IAT-eligibility. METHODS:We performed a systematic literature search to identify LAVO-prediction scales. Performance was compared in a prospective, multicenter validation cohort of the Dutch acute Stroke study (DUST) by calculating area under the receiver operating curves (AUROC). With group lasso regression analysis, we constructed a prediction model, incorporating patient characteristics next to National Institutes of Health Stroke Scale (NIHSS) items. Finally, we developed a decision tree algorithm based on dichotomized NIHSS items. RESULTS:We identified seven LAVO-prediction scales. From DUST, 1316 patients (35.8% LAVO-rate) from 14 centers were available for validation. FAST-ED and RACE had the highest AUROC (both >0.81, p?

SUBMITTER: Koster GT 

PROVIDER: S-EPMC6710617 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Clinical prediction of thrombectomy eligibility: A systematic review and 4-item decision tree.

Koster Gaia T GT   Nguyen T Truc My TTM   van Zwet Erik W EW   Garcia Bjarty L BL   Rowling Hannah R HR   Bosch J J   Schonewille Wouter J WJ   Velthuis Birgitta K BK   van den Wijngaard Ido R IR   den Hertog Heleen M HM   Roos Yvo Bwem YB   van Walderveen Marianne Aa MA   Wermer Marieke Jh MJ   Kruyt Nyika D ND  

International journal of stroke : official journal of the International Stroke Society 20180913 5


<h4>Background</h4>A clinical large anterior vessel occlusion (LAVO)-prediction scale could reduce treatment delays by allocating intra-arterial thrombectomy (IAT)-eligible patients directly to a comprehensive stroke center.<h4>Aim</h4>To subtract, validate and compare existing LAVO-prediction scales, and develop a straightforward decision support tool to assess IAT-eligibility.<h4>Methods</h4>We performed a systematic literature search to identify LAVO-prediction scales. Performance was compare  ...[more]

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