• Volker Puetz, Andrei Khomenko, Michael D Hill, Imanuel Dzialowski, Patrik Michel, Christian Weimar, Christine A C Wijman, Heinrich P Mattle, Stefan T Engelter, Keith W Muir, Thomas Pfefferkorn, David Tanne, Kristina Szabo, L Jaap Kappelle, Ale Algra, Ruediger von Kummer, Andrew M Demchuk, Wouter J Schonewille, and Basilar Artery International Cooperation Study (BASICS) Group.
• University of Technology Dresden, Dresden University Stroke Center, Department of Neurology, Fetscherstr. 74, 01307 Dresden, Germany. volker.puetz@neuro.med.tu-dresden.de
• Stroke. 2011 Dec 1;42(12):3454-9.

Background And PurposeThe posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) quantifies the extent of early ischemic changes in the posterior circulation with a 10-point grading system. We hypothesized that pc-ASPECTS applied to CT angiography source images predicts functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS).MethodsBASICS was a prospective, observational registry of consecutive patients with acute symptomatic basilar artery occlusion. Functional outcome was assessed at 1 month. We applied pc-ASPECTS to CT angiography source images of patients with CT angiography for confirmation of basilar artery occlusion. We calculated unadjusted and adjusted risk ratios (RRs) of pc-ASPECTS dichotomized at ≥8 versus <8. Primary outcome measure was favorable outcome (modified Rankin Scale scores 0-3). Secondary outcome measures were mortality and functional independence (modified Rankin Scale scores 0-2).ResultsOf 158 patients included, 78 patients had a CT angiography source images pc-ASPECTS≥8. Patients with a pc-ASPECTS≥8 more often had a favorable outcome than patients with a pc-ASPECTS<8 (crude RR, 1.7; 95% CI, 0.98-3.0). After adjustment for age, baseline National Institutes of Health Stroke Scale score, and thrombolysis, pc-ASPECTS≥8 was not related to favorable outcome (RR, 1.3; 95% CI, 0.8-2.2), but it was related to reduced mortality (RR, 0.7; 95% CI, 0.5-0.98) and functional independence (RR, 2.0; 95% CI, 1.1-3.8). In post hoc analysis, pc-ASPECTS dichotomized at ≥6 versus <6 predicted a favorable outcome (adjusted RR, 3.1; 95% CI, 1.2-7.5).Conclusionspc-ASPECTS on CT angiography source images independently predicted death and functional independence at 1 month in the CT angiography subgroup of patients in the BASICS registry.

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