The TASBAC composite score showed a strong negative correlation with NIHSS improvement (r = -0.761, P < 0.001) and 'robustly predicts early neurological recovery after thrombolysis' in acute ischemic stroke patients treated with intravenous alteplase.
Key Findings
Results
The TASBAC composite score demonstrated a strong negative correlation with neurological improvement after alteplase treatment.
TASBAC score (combining Time + Age + Stroke Severity + Blood Pressure + Atrial fibrillation + CT findings) correlated with NIHSS improvement (NIHSSDIF) at r = -0.761, P < 0.001
Pearson correlation was used for this analysis
Neurological improvement was defined as change in NIHSS (NIHSSDIF) within 72 hours post treatment
Study included 150 acute ischemic stroke patients treated with intravenous alteplase
The score was developed to quantify the combined effect of known determinants of thrombolysis outcome
Results
Door-to-needle time was negatively correlated with neurological improvement after thrombolysis.
Spearman correlation coefficient rs = -0.438, P < 0.001
This was among the stronger individual correlations observed
Nonparametric (Spearman) correlation was used for this analysis
Outcome measured as NIHSSDIF within 72 hours post treatment
Results
Baseline NIHSS score was negatively correlated with neurological improvement after thrombolysis.
Spearman correlation coefficient rs = -0.464, P < 0.001
Higher baseline stroke severity was associated with less neurological improvement within 72 hours
This correlation was among the stronger individual variable correlations observed
Results
Diastolic blood pressure was negatively correlated with neurological improvement after thrombolysis.
Spearman correlation coefficient rs = -0.477, P < 0.001
Diastolic BP showed the strongest individual variable correlation with NIHSSDIF among the variables reported
Correlation was assessed using nonparametric Spearman method
Results
Onset-to-needle time was negatively correlated with neurological improvement after thrombolysis.
Spearman correlation coefficient rs = -0.202, P = 0.013
This was the weakest of the four individual negative correlations reported
Longer onset-to-needle time was associated with less NIHSS improvement within 72 hours
Results
Presence of the dense MCA sign on CT was associated with substantially lower neurological improvement after alteplase.
Mean NIHSSDIF was 0.04 in patients with dense MCA sign versus 2.09 in those without
Dense MCA sign is an imaging finding incorporated into the TASBAC score as the CT findings component
This finding was based on a cross-sectional study of 150 acute ischemic stroke patients
Methods
The study population had a mean age of 62.7 years with a majority of male patients.
Mean age was 62.7 ± 10.4 years
57.3% of the 150 patients were male
All patients received intravenous alteplase for acute ischemic stroke
Study design was cross-sectional
What This Means
This research suggests that a new composite scoring tool called TASBAC can predict how much neurological recovery a stroke patient will experience within 72 hours of receiving the clot-dissolving drug alteplase. The score combines six factors already known to influence stroke outcomes — time to treatment, age, stroke severity, blood pressure, presence of an irregular heart rhythm (atrial fibrillation), and findings on brain CT scans. The study found that the TASBAC score had a strong correlation (r = -0.761) with neurological improvement, meaning higher scores were associated with less recovery after treatment.
The study also found that several individual factors were each independently associated with less neurological improvement: longer door-to-needle time, higher baseline stroke severity, higher diastolic blood pressure, and longer onset-to-needle time. Additionally, patients whose CT scans showed a 'dense MCA sign' — a visible clot in a major brain artery — had almost no improvement on average (mean score change of 0.04) compared to those without this finding (mean score change of 2.09).
This research suggests that combining these risk factors into a single score may give clinicians a more complete picture of a patient's likely recovery than any single factor alone. The authors propose that TASBAC could be used to help stratify patients by risk and support clinical decision-making after stroke thrombolysis. The study was conducted on 150 patients, and because it was cross-sectional in design, further prospective validation in larger and more diverse populations would be needed to confirm the score's utility in routine clinical practice.
Gedara C, Peiris J. (2026). TASBAC Composite Score Predicts Neurological Improvement after Alteplase in Acute Ischemic Stroke.. Neurology India. https://doi.org/10.4103/neurol-india.Neurol-India-D-25-00985