Imaging Factors Associated With Poor Outcome in Patients With Basilar Artery Occlusion Treated With Endovascular Thrombectomy
Bibliographic record
Abstract
Background Acute ischemic stroke attributed to basilar artery occlusion (BAO) results in high rates of death and significant morbidity. Endovascular thrombectomy an effective treatment for BAO, but imaging parameters that predict a favorable response to thrombectomy are not well defined. We determined which imaging parameters were associated with poor outcome in patients with BAO treated by thrombectomy. Methods We performed a retrospective cohort study of patients with BAO who underwent thrombectomy at multiple international stroke centers. All patients underwent computed tomography or magnetic resonance perfusion imaging before treatment. Clinical and imaging variables were measured and correlated to poor functional outcomes (modified Rankin scale score ≥4) after thrombectomy. Imaging variables included the following: Critical Area Perfusion Score, Posterior Circulation Alberta Stroke Program Early Computed Tomography Score, ischemic core volume (30% cerebral blood flow on computed tomography perfusion or diffusion‐weighted imaging), and volume of time to maximum >10 seconds. Clinical and imaging variables associated with poor functional outcome were assessed by a multivariable binary logistic regression analysis. Results A total of 102 patients were included in the study. Median patient age was 66.5 years (interquartile range [IQR], 55–78), median presentation National Institutes of Health Stroke Scale score was 14 (IQR, 7–23), and the median time from last seen normal was 4 hours (IQR, 1:52–9:20). Patient age (odds ratio [OR], 1.37 per 5‐year increment [95% CI, 1.08–1.72]; P=0.008), presentation National Institutes of Health Stroke Scale score (OR, 1.11 [95% CI, 1.04–1.18]; P=0.001), successful reperfusion after thrombectomy (OR, 0.03 [95% CI, 0.003–0.25]; P=0.002), Posterior Circulation Alberta Stroke Program Early Computed Tomography Score ≤6 (OR, 11.40 [95% CI, 1.73–75]; P=0.011), and Critical Area Perfusion Score >3 (OR, 26.22 [95% CI, 1.07–642]; P =0.045) independently predicted poor outcome after BAO thrombectomy. Ischemic core volume (30% cerebral blood flow) and volume of time to maximum >10 seconds did not predict poor outcome. Conclusion Age, National Institutes of Health Stroke Scale presentation, unsuccessful reperfusion, Critical Area Perfusion Score >3, and Posterior Circulation Alberta Stroke Program Early Computed Tomography Score ≤6 are independently associated with poor outcome after BAO thrombectomy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".