Early risk of recurrent stroke in patients with symptomatic carotid near-occlusion: Results from CAOS, a multicenter registry study.

Background The risk of recurrent stroke among patients with symptomatic carotid near-occlusion is not well established, and management of the condition remains controversial. Symptomatic carotid near-occlusion with full collapse has been identified as a strong predictor of early recurrence. We aimed to analyze the 90-day risk of recurrent ipsilateral ischemic stroke in medically treated patients with symptomatic carotid near-occlusion. Methods We performed a multicenter, nationwide, prospective study from January 2010 to May 2016. Patients with angiography-confirmed symptomatic carotid near-occlusion were included. The primary endpoint was ipsilateral ischemic stroke or transient ischemic attack (TIA) within 90 days after the presenting event. For this analysis, patients who underwent revascularization within 90 days after stroke were excluded. Results The study population comprised 141 patients from 17 Spanish centers; 83 patients were treated medically. Primary endpoint occurred in eight patients, resulting in a cumulative rate of 10.6% (95% CI, 3.7-17.5). Previous history of stroke or transient ischemic attack was identified as an independent predictor for recurrence in the multivariate Cox regression analysis (HR, 4.37 [95% CI, 1.05-18.18]; p = 0.043), while the presence of full collapse was not associated with an increased risk (HR, 0.81 [95% CI, 0.17-3.92]; p = 0.793). The risk of recurrence was also not affected by the presence of significant stenosis or occlusion of the contralateral carotid artery, or by the collateral circulation. Conclusions Patients with symptomatic carotid near-occlusion seem to have an increased risk of early ipsilateral recurrent stroke. Our results contrast with the low risk of symptomatic carotid near-occlusion reported to date. Full collapse did not increase the risk of recurrent stroke in our study.

[Spanish translation and validation of the Postural Assessment Scale for Stroke Patients (PASS) to assess balance and postural control in adult post-stroke patients]. / Traducción y validación al español de la Postural Assessment Scale for Stroke Patients (PASS) para la valoración del equilibrio y del control postural en pacientes postictus.

INTRODUCTION: In the last years the Postural Assessment Scale for Stroke Patients (PASS) has become in the most common utility to assess balance and postural control in adult patients who have suffered a stroke, especially in the acute and subacute phase. AIM: To translate the PASS into Spanish and to validate it as an instrument to evaluate balance and postural control in adult stroke patients in Spain. PATIENTS AND METHODS: The French version was translated into Spanish, this version was agreed by a team of experts. Later a back-translation was made into French and was sent to original author, who approved this version. To assess the interrater and intrarater reliability were performed four measurements on 60 post-stroke patients which was recorded a videotape. Two of these measurements were performed by the same rater, and the third and fourth by a second and third rater. RESULTS: The values refer to the total score of the scale and reflect a reliability of 0.999. They also show a reliability greater than 0.90 in each of the items in both intrarater and interrater comparisons as an internal consistency of 0.94. CONCLUSIONS: The Spanish version of PASS is valid and can reliably evaluate balance and postural control for adult stroke survivors.

TITLE: Traduccion y validacion al español de la Postural Assessment Scale for Stroke Patients (PASS) para la valoracion del equilibrio y del control postural en pacientes postictus.Introduccion. En los ultimos años, la Postural Assessment Scale for Stroke Patients (PASS) se ha convertido en la escala mas utilizada para valorar el equilibrio y el control postural en pacientes adultos que han sufrido un ictus, especialmente en la fase aguda y subaguda. Objetivo. Traducir y validar la PASS para la poblacion española como instrumento de valoracion del equilibrio y el control postural en pacientes adultos postictus. Pacientes y metodos. Se tradujo al español la version original francesa de la PASS; dicha version fue consensuada por un equipo de expertos. Posteriormente se hizo una retrotraduccion al frances y se envio al autor de la escala, el cual aprobo dicha version. Seguidamente se evaluo la fiabilidad intra e interobservador; para ello se llevaron a cabo cuatro mediciones a 60 pacientes postictus, a partir de una videograbacion. Dos de estas mediciones fueron realizadas por el mismo observador, y la tercera y cuarta, por un segundo y tercer observadores. Resultados. Los valores obtenidos referidos a la puntuacion total de la escala reflejan un indice de fiabilidad del 0,999; tambien muestran una fiabilidad superior a 0,90 en cada uno de los items, tanto en las comparaciones intraobservador como interobservador, y una consistencia interna del 0,94. Conclusion. La version española de la PASS es valida y fiable para valorar el equilibrio y el control postural en pacientes adultos postictus.

Traducción y validación al español de la Postural Assessment Scale for Stroke Patients (PASS) para la valoración del equilibrio y del control postural en pacientes postictus / Spanish translation and validation of the Postural Assessment Scale for Stroke Patients (PASS) to assess balance and postural control in adult post-stroke patients

Introducción. En los últimos años, la Postural Assessment Scale for Stroke Patients (PASS) se ha convertido en la escala más utilizada para valorar el equilibrio y el control postural en pacientes adultos que han sufrido un ictus, especialmente en la fase aguda y subaguda. Objetivo. Traducir y validar la PASS para la población española como instrumento de valoración del equilibrio y el control postural en pacientes adultos postictus. Pacientes y métodos. Se tradujo al español la versión original francesa de la PASS; dicha versión fue consensuada por un equipo de expertos. Posteriormente se hizo una retrotraducción al francés y se envió al autor de la escala, el cual aprobó dicha versión. Seguidamente se evaluó la fiabilidad intra e interobservador; para ello se llevaron a cabo cuatro mediciones a 60 pacientes postictus, a partir de una videograbación. Dos de estas mediciones fueron realizadas por el mismo observador, y la tercera y cuarta, por un segundo y tercer observadores. Resultados. Los valores obtenidos referidos a la puntuación total de la escala reflejan un índice de fiabilidad del 0,999; también muestran una fiabilidad superior a 0,90 en cada uno de los ítems, tanto en las comparaciones intraobservador como interobservador, y una consistencia interna del 0,94. Conclusión. La versión española de la PASS es válida y fiable para valorar el equilibrio y el control postural en pacientes adultos postictus (AU)

Introduction. In the last years the Postural Assessment Scale for Stroke Patients (PASS) has become in the most common utility to assess balance and postural control in adult patients who have suffered a stroke, especially in the acute and subacute phase. Aim. To translate the PASS into Spanish and to validate it as an instrument to evaluate balance and postural control in adult stroke patients in Spain. Patients and methods. The French version was translated into Spanish, this version was agreed by a team of experts. Later a back-translation was made into French and was sent to original author, who approved this version. To assess the interrater and intrarater reliability were performed four measurements on 60 post-stroke patients which was recorded a videotape. Two of these measurements were performed by the same rater, and the third and fourth by a second and third rater. Results. The values refer to the total score of the scale and reflect a reliability of 0.999. They also show a reliability greater than 0.90 in each of the items in both intrarater and interrater comparisons as an internal consistency of 0.94. Conclusi (AU)