Abstract WMP86: 24-hours Nihss As A Predictor Of 90-day Outcome In The Stratis Registry

Background: Previous studies have suggested that 24-hour NIHSS may serve as a surrogate marker for functional outcomes in acute ischemic stroke patients. Here, we examine if 24-hour NIHSS is a predictor of 90-day mRS in the prospective Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke (STRATIS) Registry. Methods: Data from the STRATIS Registry, a multicenter, non-randomized, observational study of AIS LVO patients treated with the Solitaire stent-retriever as the first-choice therapy within 8 hours from symptoms onset, were analyzed. Patients with premorbid mRS>2, posterior circulation stroke, missing 24 NIHSS or 90-day mRS were excluded from the analysis. The ability of 24-hour NIHSS (continuous and thresholds ≤6 and ≤8) to predict 90-day mRS using logistic regression was examined. The models were adjusted for age, baseline NIHSS, hypertension, diabetes, atrial fibrillation, IV-tPA use, time to recanalization, and revascularization status. Results: Of the 938 STRATIS patients, 662 with 24-hour NIHSS and 90-day mRS were included. A model trained with the continuous 24-hours NIHSS had higher predictive power (sensitivity 0.89, specificity 0.76, AUC 0.89±0.013, P<0.001) than the models trained with thresholds ≤6 and ≤8. Conclusion: When adjusted for covariates, 24-hour NIHSS as a continuous variable was the strongest predictor of dichotomous mRS outcomes in STRATIS patients. Twenty-four hour NIHSS ≤6 and ≤8 present the second and the third best results, respectively.