A Mobile Application for Predicting 90-day Outcomes after IV Thrombolysis in Ischemic Stroke (P3.069)

OBJECTIVE: To develop and validate a mobile application to estimate 90-day outcomes in ischemic stroke patients after IV thrombolysis (rt-PA) BACKGROUND: The clinical utility of scores for predicting symptomatic intracranial hemorrhage (sICH) or adverse 90-day outcome has been reported. We derived a computationally-simple score for predicting sICH to evaluate its ability to predict 90-day outcomes in an external dataset, and to develop an iOS-based mobile application to use this score at the bedside. DESIGN/METHODS: We retrospectively analyzed data from 312 patients who received IV rt-PA during the NINDS rt-PA trial. Clinical outcomes were assessed at 90 days using modified Rankin Scale (mRS) scores. Adverse and favorable outcomes were defined as mRS 蠅 5, and mRS ≤ 1. Agreement between our clinical score and clinical outcomes were assessed using univariate logistic regression reporting odds ratios, Hosmer-Lemeshow statistics and areas under the ROC curve. P-values < 0.05 (two-tailed) were considered statistically significant. An iOS-based mobile application was developed to implement our score. Inputs were prestroke mRS score and admission NIHSS score. Outputs were probability of 90-day adverse outcome and probability of 90-day favorable outcome. RESULTS: Our clinical score predicted adverse outcome with an odds ratio of 6, P 2 of 3.42, P = 0.9 and area under the ROC curve of 0.83, 95[percnt] CI (0.78, 0.88). Favorable outcome was predicted by the orthogonal function with an odds ratio of 5.2, P 2 of 14.76, P = 0.06 and area under the ROC curve of 0.8, 95[percnt] CI (0.75, 0.85). The iOS mobile application produced identical results for individual patients. CONCLUSIONS: W e evaluated the ability of our score to predict 90-day outcomes and developed an iOS application based on results. Our mobile application brings a unique opportunity to optimize rT-PA treatment decisions for acute ischemic stroke patients. Disclosure: Dr. Nystrom has nothing to disclose. Dr. Asuzu has nothing to disclose. Dr. Amin has nothing to disclose. Dr. Schindler has nothing to disclose. Dr. Wira has nothing to disclose. Dr. Greer has received personal compensation in an editorial capacity for Seminars in Neurology. Dr. Chi has nothing to disclose. Dr. Halliday has nothing to disclose. Dr. Sheth has received research support from the American Academy of Neurology Foundation, the American Heart Association, the Passano Foundation, and Remedy Pharmaceuticals.