RESUMEN
BACKGROUND: THRIVE (Totaled Health Risks in Vascular Events) score is a tool used to predict the functional outcome and mortality in patients with ischemic stroke at 3 months. This project aims to explore its prognostic value at 3, 6, and 12 months in Chinese stroke patients. METHODS: We applied the THRIVE score in 11,064 patients with acute ischemic stroke who were entered into the China National Stroke Registry. We applied the THRIVE score and examined its performance on mortality and poor functional outcome (modified Rankin Scale score between 3 and 6). Model discrimination was measured by c-statistic. Calibration was assessed by comparing predicted and observed probability of poor outcome or mortality by using Pearson correlation coefficient. RESULTS: Among the 11,064 patients with ischemic stroke, the mortality rates at discharge, and at 3, 6, and 12 months were 3.6%, 7.9%, 10.5%, and 12.7%, respectively; the corresponding c-statistics were .83(95% confidence interval [CI], .80-.86), .79(95% CI, .77-.81), .80(95% CI, .78-.81), and .79(95% CI, .78-.80), respectively. For the poor functional outcome at discharge, and at 3, 6, and 12 months, the c-statistics were .74(95% CI, .73-.75), .76(95% CI, .75-.77), .76(95% CI, .75-.77), and .77(95% CI, .76-.78), respectively. The observed and expected probability of poor functional outcome and mortality based on the THRIVE score correlated (Pearson correlation coefficient ranged from .90 to .99) highly. CONCLUSIONS: The THRIVE score is a reliable tool to predict the mortality and to fairly predict the functional outcome at discharge, and at 3, 6, and 12 months in Chinese patients after acute ischemic stroke.
Asunto(s)
Isquemia Encefálica/diagnóstico , Técnicas de Apoyo para la Decisión , Accidente Cerebrovascular/diagnóstico , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Isquemia Encefálica/mortalidad , Isquemia Encefálica/fisiopatología , Isquemia Encefálica/terapia , Niño , China , Comorbilidad , Evaluación de la Discapacidad , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Alta del Paciente , Valor Predictivo de las Pruebas , Curva ROC , Recuperación de la Función , Sistema de Registros , Reproducibilidad de los Resultados , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/terapia , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND AND PURPOSE: The ASTRAL score was recently introduced as a prognostic tool for acute ischemic stroke. It predicts 3-month outcome reliably in both the derivation and the validation European cohorts. We aimed to validate the ASTRAL score in a Chinese stroke population and moreover to explore its prognostic value to predict 12-month outcome. METHODS: We applied the ASTRAL score to acute ischemic stroke patients admitted to 132 study sites of the China National Stroke Registry. Unfavorable outcome was assessed as a modified Rankin Scale score >2 at 3 and 12 months. Areas under the curve were calculated to quantify the prognostic value. Calibration was assessed by comparing predicted and observed probability of unfavorable outcome using Pearson correlation coefficient. RESULTS: Among 3755 patients, 1473 (39.7%) had 3-month unfavorable outcome. Areas under the curve for 3 and 12 months were 0.82 and 0.81, respectively. There was high correlation between observed and expected probability of unfavorable 3- and 12-month outcome (Pearson correlation coefficient: 0.964 and 0.963, respectively). CONCLUSIONS: ASTRAL score is a reliable tool to predict unfavorable outcome at 3 and 12 months after acute ischemic stroke in the Chinese population. It is a useful tool that can be readily applied in clinical practice to risk-stratify acute stroke patients.