How to Define Fast and Slow Progressors in Any-Type Occlusion Acute Ischemic Stroke. (11th March 2023)

• Record Type: Journal Article
• Authors: Nomani, Ali Z.; Rempel, Jeremy L.; Khan, Khurshid A.; Shuaib, Ashfaq; Jickling, Glen C.
• Is Part Of: Canadian journal of neurological sciences. Volume 50:Number 2(2023)
• Page Start: 268
• Page End: 273
• Publication Date: 2023-03-11
• Subjects: Hypoperfusion index -- Hypoperfusion intensity ratio -- Stroke progression -- Rate of infarct growth -- Acute ischemic stroke; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Electronic journals; 616.8
• DOI: 10.1017/cjn.2022.9
• Languages: English
• ISSNs: 0317-1671

Abstract

ABSTRACT: The variable rate of infarct progression in acute ischemic stroke as assessed by various thresholds excludes a substantial proportion of patients due to time or core constraints. We evaluated 106 patients with any-type occlusion to compare these thresholds and assessed performance of hypoperfusion index (HI) for fast and slow rate of infarct progression. Seven (12.5%) were classified fast progressors and 23 (46%), 25 (50%), 12 (24%), and 33 (66%) slow progressors using different core and time criteria. In comparison, HI categorized 100% ( n = 106) of cohort with optimal cutoff 0.5 for any-type occlusion (slow progressors: HI ≤ 0.5), sensitivity/specificity 100%/91%, AUC 0.94, and indicative of eligibility for reperfusion and clinical outcomes (median 90-day modified Rankin Scale; 2 for HI ≤ 0.5 versus 5). Estimation of progressors by HI seems comprehensive but needs external validation.