Do Pretreatment CT Scoring Systems Affect the Safety and Efficacy of Thrombolytic Therapy for Acute Ischemic Stroke?
Prospective evaluation of CT scoring systems was not available, and both included studies are evaluations of CT’s conducted during the course of prospective trials of thrombolysis in stroke. Barber and colleagues256 evaluated 203 consecutive patients treated with thrombolytic therapy within 3-hours of prospective scoring of their CT scans according to a 10-point scale based on an unenhanced axial CT scan. The value was calculated from two cuts within the MCA territory. A normal scan obtained a score of 10 points with one point subtracted for each area of early ischemic change. The ASPECTS Score correlated with baseline NIH Stroke Scale Score in an inverse manner (Spearman’s rho = -0.56, p < 0.001). An ASPECTS Score of less than 7 had strong predictive value for death or dependence. With dependence defined as a Rankin Score of 3 to 5, the odds ratio for good functional outcome was 82 (95% CI 23–290). Similarly, an ASPECTS Score of less than or equal to 7 was predictive of the presence o
