Prognostic Accuracy of Five Collateral Circulation Scores derived from computed tomography angiography for Predicting 3-Month Outcomes in Acute Ischemic Stroke

Purpose This study aims to explore the optimal collateral circulation score for predicting 3-month function outcomes in patients with acute ischemic stroke. Methods We included patients with acute ischemic stroke. Five collateral circulation scores derived from computed tomography angiography(CTA) including the Maas score, Tan score, rLMC score, Miteff score, and ASPECTS score were assessed. The outcome measure was poor functional outcomes at 3 months, defined as a modified Rankin Scale (mRS) score of 3–6. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prognostic performance of each score. Sensitivity analyses were conducted by only including patients with large artery stenosis (stenosis > 30%) or those who did not receive reperfusion therapy. Results A total of 515 patients with acute ischemic stroke within 24 hours of onset were included, with a mean age of 67.1 ± 14.3 years and 59.2% were male. The proportion of patients received reperfusion therapy was 19.2%(99/515 cases). 252 patients had poor functional outcomes after 3-month follow-up. The rLMC score demonstrated the highest area under the curve (AUC) for predicting poor functional outcomes (AUC = 0.677), followed by the Tan score (AUC = 0.669), Maas score (AUC = 0.668), Miteff score (AUC = 0.666), and ASPECTS score (AUC = 0.660). Similar results were found in sensitivity analysis. Conclusion The rLMC score shows the highest prognostic accuracy for predicting 3-month poor outcomes in patients with acute ischemic stroke. The results remained when only included patients with large artery stenosis/occlusion or patients without reperfusion treatment.