Long-Term Prediction of Functional Outcome After Stroke Using the Alberta Stroke Program Early Computed Tomography Score in the Subacute Stage
Long-Term Prediction of Functional Outcome After Stroke Using the Alberta Stroke Program Early Computed Tomography Score in the Subacute Stage
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DOI：
10.1016/j.jstrokecerebrovasdis.2011.03.010
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发表时间：
2012-11-01
影响因子：
2.5
通讯作者：
Black, Sandra E.
中科院分区：
文献类型：
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作者：
Alexander, Lisa D.;Pettersen, Jacqueline A.;Black, Sandra E.
在症状出现超过24小时后到达医院的中风患者可以受益于一种简单的方法来评估这一亚急性阶段的长期预后。我们用阿尔伯塔省卒中计划的早期计算机断层扫描评分(Aspects)评估临床因素和缺血性损伤是否对卒中后的功能独立性有预测价值。3位卒中神经科医师使用Aspects对首次缺血性卒中后2天的CT扫描进行了独立的、回顾性的评分。使用功能独立性测量来衡量功能结果，该测量评估患者在日常活动中所需的照顾者援助的量。采用多元线性回归建立卒中后1个月、3个月和1年的功能预后预测模型。我们的55例患者平均在中风后4天进行CT扫描。评价者之间对亚急性方面的一致性非常好，卡伯权重值为0.90。在研究的所有3个时间点，累及额叶和顶上区域的病变是功能独立性测量得分较低的显著预测因素。结合年龄、婚姻状况和最初神经功能缺失的严重程度等因素，亚急性方面评分>；5对3个月后功能独立性增强有显著的预测价值(R-2=0.701；P
Stroke patients who arrive at hospital more than 24 hours after symptom onset could benefit from a simple means of assessing long-term prognosis in this subacute stage. We evaluated whether clinical factors along with ischemic injury assessed subacutely using the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) had predictive value for functional independence after stroke. Computed tomography (CT) scans obtained >= 2 days after first-ever ischemic stroke were scored independently and retrospectively by 3 stroke neurologists using the ASPECTS. Functional outcome was measured using the Functional Independence Measure, which assesses the amount of caregiver assistance required by patients during daily activities. Multiple linear regression was used to develop a predictive model for functional prognosis at 1 month, 3 months, and 1 year poststroke. For our 55 patients, CT scanning was done on average 4 days poststroke. The interrater agreement for subacute ASPECTS was excellent, with a kappa-weighted value of 0.90. Lesions involving the frontal and superior parietal ASPECTS regions were significant predictors of lower Functional Independence Measure scores at all 3 time points studied. In combination with such factors as age, marital status, and the severity of initial neurologic deficit, a subacute ASPECTS score >5 had significant predictive value for greater functional independence at 3 months (R-2 = 0.701; P