Hierarchical composite outcomes in acute ischaemic stroke with large infarct: a win ratio analysis of the TENSION trial - PubMed
5 hours ago
- #hierarchical composite outcomes
- #acute ischaemic stroke
- #win ratio analysis
- The win ratio analysis was applied to the TENSION trial, comparing EVT + BMT versus BMT alone in acute ischaemic stroke with large infarct.
- The hierarchical composite outcome prioritized endpoints as: time to death, mRS at 12 months, serious adverse events, and EuroQOL 5-dimension scores at 12 months.
- The overall win ratio was 1.61 (95% CI 1.19-2.18, P=0.002), showing a 60% win frequency for EVT + BMT, with 22.8% win difference largely driven by survival benefits.
- Results were consistent across subgroups including age, sex, baseline mRS, consciousness, ASPECTS 5, and M1 occlusions.
- The win ratio complements traditional mRS-based analyses, highlighting how endpoint ordering affects treatment effect estimates, mainly through improved survival.