Verification of Clot Burden Score Prognostic Value in Acute Middle Cerebral Artery Ischemic Insults

Abstract Background The Clot Burden Score (CBS) is a CT angiography-based grading system used to assess thrombus burden in acute ischemic stroke patients. CBS is a major determinant of stroke severity and outcome in anterior circulation stroke, offering advantages over invasive angiographic scores. Aim of the Work to investigate the prognostic value of CBS in predicting clinical outcomes using the modified Rankin Scale (mRS). Patients and Methods Type of study combined prospective and retrospective observational study. Sampling Method purposive sampling according to inclusion and exclusion criteria. Results The study included 40 patients with acute ischemic stroke, with a mean age of 58.35 ± 14.82 years. 60% of patients were male, and 40% were female. After 3 months, 17 patients (42.5%) achieved functional independence (mRS ≤ 2), while 23 patients (57.5%) had higher mRS scores (22 functionally dependent and 1 deceased). There was a statistically significant inverse correlation between CBS and mRS scores, indicating that patients with higher CBS scores had lower mRS scores. Receiver Operating Characteristic (ROC) curve analysis determined a CBS cutoff value of greater than 6 as predictive of a good prognosis, with high sensitivity and specificity. Conclusion The current study shows that CBS is a good predictor of patient outcome. It is a relatively easy and simple method in quantifying clot burden, apart from being systematic. This assists in selection of treatment strategies, and prognosticates patient outcome; and can be incorporated in routine radiological reporting of AIS cases.