NDLI: The totaled health risks in vascular events (THRIVE) score predicts ischemic stroke outcomes independent of thrombolytic therapy in the NINDS tPA trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kamel, Hooman Patel, Nihar Rao, Vivek A. Cullen, Sean P. Faigeles, Bonnie S. Smith, Wade S. Flint, Alexander C.
Spatial Coverage	United States
Description	Author Affiliation: Kamel H ( Department of Neurology and Neuroscience, Weill Cornell Medical College, New York.)
Abstract	BACKGROUND: To date, no ischemic stroke outcome prediction scores have been validated for use in the setting of both endovascular and non-endovascular stroke treatments. The Totaled Health Risks in Vascular Events (THRIVE) score has been previously validated in patients undergoing endovascular stroke treatment, and we hypothesized that it would perform similarly well in patients receiving intravenous tissue plasminogen activator (tPA) or no acute therapy. METHODS: We compared the performance of the THRIVE score between patients in the National Institutes of Neurological Disorders and Stroke (NINDS) tPA trial and patients in the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trials of endovascular stroke treatment. The predictive performance of the THRIVE score was compared using receiver operator characteristic (ROC) curve analysis. In the NINDS cohort, separate analyses were also performed for patients receiving tPA versus those receiving placebo. RESULTS: ROC curve analysis revealed a good prediction of outcomes across the range of THRIVE scores in both the NINDS and MERCI datasets. As we have previously found in the MERCI datasets, the THRIVE score, which encompasses the National Institutes of Health Stroke Scale (NIHSS) score, age, and chronic disease burden, was a better predictor of outcomes than NIHSS and age alone in the NINDS trial dataset. THRIVE score and tPA administration both strongly predicted outcome, but these effects were statistically independent. CONCLUSIONS: The THRIVE score provides accurate prediction of long-term neurologic outcomes in patients with acute ischemic stroke regardless of treatment modality. Both the THRIVE score and tPA administration predict outcome, but the THRIVE score does not influence the impact of tPA on outcome, and tPA administration does not influence the impact of THRIVE score on outcome.
File Format	HTM / HTML
ISSN	10523057
Issue Number	7
Volume Number	22
e-ISSN	15328511
Journal	Journal of Stroke and Cerebrovascular Diseases
Language	English
Publisher	Elsevier
Publisher Date	2013-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Brain Ischemia Stroke Prognosis United States Humans Middle Aged Drug Therapy Male Treatment Outcome Administration & Dosage National Institute Of Neurological Disorders And Stroke Predictive Value Of Tests Fibrinolytic Agents Therapeutic Use Journal Article Tissue Plasminogen Activator Discipline Cardiology Thrombolytic Therapy Adult Female Aged Research Design
Content Type	Text
Resource Type	Article
Subject	Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine

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