Correlation of the Alberta Stroke Program Early CT Score (ASPECTS) and Functional Outcomes in Acute Ischemic Stroke Patients Who Received Intravenous Recombinant Tissue Plasminogen Activator at Phonthong Hospital in Roi-Et Province

Abstract

This research aimed to assess correlation between the Alberta Stroke Program Early CT Score (ASPECTS) and functional outcomes of acute ischemic stroke patient who arrived the hospital within 4.5 hours of stroke onset. It was conducted at Phonthong Hospital, Roi-et Province between November 2014 and April 2017. There were altogether 58 patients with clinical acute ischemic stroke who received intravenous (IV) recombinant tissue plasminogen activator (iv rt-PA) within 270 minutes from the onset of stroke symptoms. The median age was 66 years old with the range of 34-89 years old; and 28 of them were male; had median ASPECTES of 9 (range: 6-10). The early functional outcomes (at discharge) evaluated by Barthel Activity of Daily Living Index (BI) and modified Rankin Scale (mRS) were significantly better for the cases with the better ASPECTS score than those with the worse ones (p=0.012 and 0.002, respectively). Furthermore, baseline ASPECTS scores, Hyperdense middle cerebral artery (MCA) sign, National Institutes of Health Stroke Scale (NIHSS) at ER, NIHSS at admission, BI at admission, mRS at admission and NIHSS at discharge were important factors for prophesying functional outcomes after IV rt-PA. Therefore, the use of ASPECTS in pretreatment non-contrast CT could help making proper treatment decision and predicting functional outcomes at discharge in patients with acute ischemic stroke receiving iv rt-PA; and patients with ASPECTS >7 had a better prognosis.