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January 1, 2013Cerebrovascular Diseases394 citations

The ASCOD Phenotyping of Ischemic Stroke (Updated ASCO Phenotyping)

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PAPierre AmarencoJBJulien BogousslavskyLCLouis R. Caplan

Key Points

  • This study aims to enhance the ASCO phenotyping system by integrating additional factors affecting ischemic stroke.
  • Introduced a new category for dissection and simplified diagnostic evidence levels.
  • Updated the cutoff for significant stenosis from 70% to 50%.
  • Incorporated a cardiogenic stroke pattern based on neuroimaging.
  • ASCOD better accounts for overlapping diseases in ischemic stroke patients.
  • Improved the accuracy of categorizing stroke causes, especially in younger patients.

Abstract

ASCO phenotyping (A: atherosclerosis; S: small-vessel disease; C: cardiac pathology; O: other causes) assigns a degree of likelihood of causal relationship to every potential disease (1 for potentially causal, 2 for causality is uncertain, 3 for unlikely causal but the disease is present, 0 for absence of disease, and 9 for insufficient workup to rule out the disease) commonly encountered in ischemic stroke describing all underlying diseases in every patient. In this new evolution of ASCO called ASCOD, we have added a 'D' for dissection, recognizing that dissection is a very frequent disease in young stroke patients. We have also simplified the system by leaving out the 'levels of diagnostic evidence', which has been integrated into grades 9 and 0. Moreover, we have also changed the cutoff for significant carotid or intracranial stenosis from 70% to more commonly used 50% luminal stenosis, and added a cardiogenic stroke pattern using neuroimaging. ASCOD captures and weights the overlap between all underlying diseases present in ischemic stroke patients.

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Cite This Study

Amarenco et al. (2013) studied this question.

synapsesocial.com/papers/69d843f905ee2ba81dbef643https://doi.org/10.1159/000352050
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