The Relationship of Alberta Stroke Program Early CT Score (ASPECTS) and Risk Factors Related to Disability at 90 Days Using Modified Rankin Scale (mRS) in Acute Ischemic Stroke Patients Receiving rTPA at Sunpasitthiprasong Hospital

Abstract

          Background: Acute ischemic stroke is an important state of emergency for internal medicine. The treatment importance depends on duration and proper treatment among individual patients. The evaluation is considered by post-treatment disability. Therefore, pre-treatment CT brain non contrast evaluation from the data collection of a large number of population and long-term follow-up are required. Objective : To study the relationship of ASPECTS from CT brain imaging and other risk factors. The unfavorable outcome is the disability after 90 days of rTPA, evaluated by modified Rankin scale, in patients with ischemic strokes in Sunpasitthiprasong Hospital. Method: This research is a cross-sectional study through data collection from in-patient medical records, Internal Medicine Department, Sunpasitthiprasong Hospital, Ubonratchathani Province. The data were collected from January 1, 2013 to December 31, 2017. The collected basic data included basic profiles, vital signs, blood results, rTPA treatment durations, National Institutes of Health Stroke Scale (NIHSS) and intracranial hemorrhage. A relationship between patients’ data including Alberta Stroke program Early CT Score (ASPECTS) and patients’ wellbeing was explored according to modified Rankin Scale(mRS), Defined Group 1 is mRS less than or equal to 1, meaning low disability and Group 2 is mRS more than 1, meaning high disability. ASPECTs and mRS on 90-day datas using multivariate logistics were studied. Result: Of 187 patients, 98 (52%) were females, whose average ages (SD) were 67 (14.4) years, with ASPECTS of 4-10 with mean (SD) of 8.18 (1.20), median of 8.0. The result revealed that 104 (55.6%) had high level of disability. And NIHSS prior to discharge had a significantly relationship with disability (OR= 0.652 (95%CI 0.558-0.761) P-value<0.001). The relationship between ASPECTS and disability was not shown in this research. Conclusion : There is no relationship between post-rTPA disability evaluating by mRS at 90 days after discharge and ASPECTS.
Keyword: Acute ischemic stroke , risk factor, disability , ASAECTS