External Validation of the Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) Score for Predicting Stroke-Associated Pneumonia in the Athens Stroke Registry.
J Stroke Cerebrovasc Dis
; 24(11): 2619-24, 2015 Nov.
Article
em En
| MEDLINE
| ID: mdl-26347399
ABSTRACT
BACKGROUND AND PURPOSE:
The Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score was developed recently for predicting stroke-associated pneumonia (SAP), one of the most common complications after stroke. The aim of the present study was to externally validate the ISAN score.METHODS:
Data included in the Athens Stroke Registry between June 1992 and December 2011 were used for this analysis. Inclusion criteria were the availability of all ISAN score variables (prestroke independence, sex, age, National Institutes of Health Stroke Scale score). Receiver operating characteristic curves and linear regression analyses were used to determine the discriminatory power of the score and to assess the correlation between actual and predicted pneumonia in the study population. Separate analyses were performed for patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH).RESULTS:
The analysis included 3204 patients (AIS 2732, ICH 472). The ISAN score demonstrated excellent discrimination in patients with AIS (area under the curve [AUC] .83 [95% confidence interval {CI} .81-.85]). In the ICH group, the score was less effective (AUC .69 [95% CI .63-.74]). Higher-risk groups of ISAN score were associated with an increased relative risk of SAP; risk increase was more prominent in the AIS population. Predicted pneumonia correlated very well with actual pneumonia (AIS group R(2) = .885; ß-coefficient = .941, P < .001; ICH group R(2) = .880, ß-coefficient = .938, P < .001).CONCLUSIONS:
In our external validation in the Athens Stroke Registry cohort, the ISAN score predicted SAP very accurately in AIS patients and demonstrated good discriminatory power in the ICH group. Further validation and assessment of clinical usefulness would strengthen the score's utility further.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonia
/
Índice de Gravidade de Doença
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Hemorragia Cerebral
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Sistema de Registros
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Acidente Vascular Cerebral
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article