A Comparison of Mortality Prognostic Scores in Ischemic Stroke Patients

J Stroke Cerebrovasc Dis. 2016 Feb;25(2):241-7. doi: 10.1016/j.jstrokecerebrovasdis.2015.09.021. Epub 2015 Nov 30.

Abstract

Objective: Our objective is to compare the predictive accuracy of 4 recently established stroke mortality scores in the Chinese population, including the Get With The Guidelines-Stroke risk score, the iScore prediction rule for 30-day mortality, the iScore prediction rule for 1-year mortality, and the PLAN score.

Methods: We analyzed data from 9698 hospitalized patients with acute ischemic stroke in the China National Stroke Registry (September 2007-August 2008). Outcome measures were in-hospital mortality, 30-day mortality, and 1-year mortality. To evaluate the performance of each model, we calculated the area under the receiver operating characteristic curve. The areas under the curve (AUCs) were compared using the z-test.

Results: Among 9698 patients, the mean age was 65.5 years and 38.6% were female. Overall in-hospital mortality, 30-day mortality, and 1-year mortality were 3.0%, 5.9%, and 14.6%, respectively. The AUC values of 4 scores for each outcome were all more than .75. The z-test did not show significant difference among the AUC values of these 4 scores. For patients who received thrombolysis therapy, these 4 scores had apparent reductions in the AUC values.

Conclusions: We could confirm the predictive value of all these 4 scores for short-term and long-term mortalities in Chinese IS patients. However, these 4 scores need to be interpreted with caution in the patients who received thrombolysis therapy.

Keywords: Ischemic stroke; mortality; prognosis; risk factor.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / mortality*
  • China
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Registries
  • Severity of Illness Index
  • Stroke / mortality*
  • Young Adult