The GOAT-R score, which includes age, cardiac disease, baseline mRS, NIHSS, and GFR, predicted poor outcomes in stroke patients with a c-statistic of 0.75 in validation.
Does the GOAT-R score accurately predict poor 30-day functional outcomes in acute ischemic stroke patients treated with intravenous thrombolytics?
The GOAT-R score provides an accurate and simple tool to predict poor 30-day functional outcomes in acute ischemic stroke patients treated with thrombolytics, particularly useful for guiding early conversations in rural settings.
Absolute Event Rate: 0% vs 0%
Objective: To develop a predictive tool that is accurate and easy to use for short-term functional outcomes for ischemic stroke patients treated with thrombolysis in the rural setting. Methods: This multicenter retrospective study utilized an Integrated Health System Rural Stroke Network Registry as a derivation cohort and a large urban academic hospital with a Comprehensive Stroke Center designation database as a validation cohort. Demographics, clinical, laboratory, and radiographic data were collected. A poor short-term outcome was defined as a 30-day mRS score of 5 or higher. A backward logistic regression analysis was developed based on the clinical significance of the dependent variables, and a 5-point predictive score system (GOAT-R) was developed based on clinical plausibility and practicality. A calibration curve was designed. The score was tested on the validation cohort. P-value was set at 0.05 for all statistical analyses. Results: Of 222 patients included in the derivation cohort, 35 (16%) had a poor short-term outcome. In a backward logistic regression model, baseline mRS (OR:1.511, 95% CI:1.047-2.182, p=0.02), and NIHSS (OR:1.136, 95% CI:1.063-1.214, p 75, cardiac disease, baseline mRS > 2, NIHSS ≥ 20, and GFR < 40. The c-statistic of the model was 0.79, 95% CI: 0.71 – 0.87. In the validation cohort of 200 patients, the model performed with a c-statistic of 0.75, 95% CI: 0.64 – 0.86. Conclusions: The GOAT-R score is an accurate and easy-to-use aiding tool to help providers in rural settings guide early conversations with stroke patients and their families. Providing rural settings with inexpensive and accurate prognostic tools is a crucial step in bridging the gap in stroke care between urban and rural areas.
Robayo et al. (Thu,) reported a other. The GOAT-R score, which includes age, cardiac disease, baseline mRS, NIHSS, and GFR, predicted poor outcomes in stroke patients with a c-statistic of 0.75 in validation.