The following is a summary of “External validation of clinical risk prediction score for elderly treated with endovascular thrombectomy,” published in the July 2024 issue of Neurology by Enriquez et al.

To aid treatment decisions, thrombectomy in the elderly prediction score (TERPS) is developed as a scoring system predicting functional recovery in patients experiencing stroke aged ≥80 undergoing endovascular therapy (EVT) for frontal blockages.

Researchers conducted a retrospective study to evaluate factors affecting elderly patients and their outcomes and confirm the effectiveness of the new TERPS prediction model.

They assessed the eligibility of consecutive patients undergoing EVT from the Oslo Acute Reperfusion Stroke Study. They computed the TERPS based on clinical and radiological factors and evaluated functional outcomes after 3 months.

The results showed 1,028 patients undergoing EVT for acute ischemic stroke (January 2017 to July 2022), 218 (21.2%) were ≥ 80 years old with anterior ischemic stroke. Achieving a modified Rankin scale (mRS) score of ≤ 3 (fair outcome) in 117 (53.7%). In bivariate analyses, factors associated with fair outcome included male sex (P=0.035), age (P=0.025), baseline National Institute of Health Stroke Scale (NIHSS, P<0.001), pre-stroke mRS (P=0.002), and Alberta Stroke Program Early Computed Tomography score (ASPECTS, P=0.001). Lower pre-stroke mRS was a significant predictor for fair outcome in regression analyses, aOR 0.67 (95% CI 0.50–0.91, P=0.01), as well as NIHSS, aOR 0.92 (95% CI 0.87–0.97, P=0.002), and higher ASPECTS, aOR 1.22 (95% CI 1.03–1.44, P=0.023). The area under the curve (AUC) using TERPS was 0.74 (95% CI 0.67–0.80).

Investigators found TERPS moderately effective in this external validation, suggesting further refinement with additional variables and testing in new patient groups.

Source: link.springer.com/article/10.1007/s00415-024-12535-6