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Prediction of functional outcome and tissue loss in acute cortical infarction
M G Chua1, S M Davis, B Infeld
1The University, Department of Medicine, Royal Melbourne Hospital, Victoria, Australia.
Objective:
To compare the acute Allen's Prognostic Score, Canadian Neurological Score, and subacute Barthel Index as predictors of outcome functional status and infarct size at 3 months in patients with acute cortical infarction.
Design:
A prospective study of acute stroke predictors and outcome measurements in a cohort of sequential hospitalized patients.
Patients:
Fifty-one patients with acute cortical infarction and without previous disability assessed 24 hours after onset with Allen's Prognostic Score and the Canadian Neurological Score and at 7 days with the Barthel Index.
Main Outcome Measures:
Mortality, Barthel Index, and volumetric measurement of infarct size on computed tomography 3 months after stroke.
Results:
There were seven deaths. The outcome Barthel Index was measured in all 44 survivors, of whom 29 had computed tomography at the time outcome was determined. In a multivariate analysis, functional outcome was best predicted by Allen's Prognostic Score, a score of less than -15 having a sensitivity of 82% and specificity of 97% in predicting a poor outcome (Barthel Index, < or = 12 or death). Volumetric tissue loss was predicted only by Allen's Prognostic Score (r = .62, P < .001).
Conclusions:
Allen's Prognostic Score is a robust predictor of both functional outcome and tissue loss in acute cortical infarction and has a potentially important role in the analysis of the results of acute stroke intervention trials.