Predicting functional outcome after stroke by modelling baseline clinical and CT variables
Predicting functional outcome after stroke by modelling baseline clinical and CT variables
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DOI：
10.1093/ageing/afq027
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发表时间：
2010-05-01
期刊：
影响因子：
6.7
通讯作者：
Phillips, Stephen J.
中科院分区：
文献类型：
--
作者：
Reid, John M.;Gubitz, Gord J.;Phillips, Stephen J.
方法：2001年至2002年间，538例急性缺血性和出血性卒中患者连续入选卒中结局研究。在6个月时评估独立生存率（改良兰金量表< 2）。模型的基础上，从第一次评估的临床和放射学变量，采用多变量logistic回归analysis.Results：三个模型（I-III）。模型I包括年龄、卒中前独立性、臂力和卒中严重程度评分（受试者工作特征曲线下的面积，AUC = 0.882），但其表现并不优于模型II，后者包括年龄、卒中前独立性、格拉斯哥昏迷评分的正常语言部分、臂力和能够在没有辅助的情况下行走（AUC 0.876）。模型III，包括两个放射学变量和临床变量，在统计学上不上级模型II（AUC 0.901，P = 0.12）。模型II在两个独立的数据集（AUC为0.773和0.787）中进行了外部验证。结论：本研究使用简单的临床变量证明了外部验证的卒中结局预测模型。结果预测没有显着改善与CT衍生的放射学变量或更复杂的临床变量。
Methods: 538 consecutive acute ischaemic and haemorrhagic stroke patients were enrolled in a Stroke Outcome Study between 2001 and 2002. Independent survival (modified Rankin scale < 2) was assessed at 6 months. Models based on clinical and radiological variables from the first assessment were developed using multivariate logistic regression analysis.Results: three models were developed (I-III). Model I included age, pre-stroke independence, arm power and a stroke severity score (area under a receiver operating characteristic curve, AUC = 0.882) but performed no better than Model II, which comprised age, pre-stroke independence, normal verbal component of the Glasgow coma score, arm power and being able to walk without assistance (AUC 0.876). Model III, including two radiological variables and clinical variables, was not statistically superior to model II (AUC 0.901, P = 0.12). Model II was externally validated in two independent datasets (AUCs of 0.773 and 0.787).Conclusion: this study demonstrates an externally validated stroke outcome prediction model using simple clinical variables. Outcome prediction was not significantly improved with CT-derived radiological variables or more complex clinical variables.