TASBAC Composite Score Predicts Neurological Improvement after Alteplase in Acute Ischemic Stroke

Abstract: Background: Time to treatment, baseline stroke severity, blood pressure, age, atrial fibrillation, and imaging findings are known determinants of outcome after thrombolysis. Their combined effect has not been well quantified. Methods: We conducted a cross-sectional study of 150 acute ischemic stroke patients treated with intravenous alteplase. We developed the TASBAC score (Time + Age + Stroke Severity + Blood Pressure + Atrial fibrillation + CT findings). Neurological improvement was defined as the change in NIHSS (NIHSSDIF) within 72 hours post treatment. Nonparametric (Spearman) and parametric (Pearson) correlations were used; significance was set at P < 0.05. Results: The mean age was 62.7 ± 10.4 years; 57.3% were male. Onset-to-needle time, door-to-needle time, baseline NIHSS, and diastolic BP were negatively correlated with NIHSSDIF (rₛ = –0.202, P = 0.013; –0.438, P < 0.001; –0.464, P < 0.001; –0.477, P < 0.001, respectively). Dense MCA sign was associated with lower NIHSS improvement (mean 0.04 vs. 2.09). TASBAC score showed a strong negative correlation with NIHSS improvement (r = –0.761, P < 0.001). Conclusions: TASBAC quantifies cumulative risk and robustly predicts early neurological recovery after thrombolysis. It may help in clinical stratification and decision-making.