Abstract
Background:
The HERMES-24 score has recently been proposed to estimate the 90-day outcome in patients with anterior circulation large vessel occlusion (LVO) stroke.
Aim:
We aimed to further validate the HERMES-24 score in a real-world setting of LVO patients who had received endovascular stroke treatment (EVT).
Methods:
We used data of consecutive LVO patients treated with EVT in six Austrian stroke centers. The performance of the HERMES-24 score for outcome prediction at 90 days (modified Rankin Scale (mRS)) was investigated in predefined subgroups of anterior and vertebrobasilar LVO and within or beyond 6 h/unknown time windows.
Results:
We analyzed 1571 patients with available 90-day follow-up. The HERMES-24 score was predictive of 90-day mRS ⩽ 2 for the total cohort, those with anterior LVO <6 h, anterior LVO ⩾6 h/unknown, vertebrobasilar LVO < 6 h, and vertebrobasilar LVO ⩾ 6 h/unknown with c-statistics (95% confidence interval (CI)) 0.90 (0.88–0.92), 0.90 (0.88–0.92), 0.89 (0.86–0.92), 0.88 (0.79–0.98) and 0.98 (0.96–1.0), respectively. The HERMES-24 score also yielded excellent outcome prediction for 90-day mRS ⩽ 3, an ordinal mRS, and mortality in all subgroups (c-statistics: 0.83–0.99).
Conclusion:
The HERMES-24 score is highly predictive for 90-day outcome in real-world patients with LVO stroke treated with EVT regardless of LVO localization or symptom onset to treatment time.
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