The Prognostic Value of the iScore, the PLAN Score, and the ASTRAL Score in Acute Ischemic Stroke

J Stroke Cerebrovasc Dis. 2017 Jun;26(6):1233-1238. doi: 10.1016/j.jstrokecerebrovasdis.2017.01.013. Epub 2017 Feb 22.

Abstract

Background: Disability and mortality represent the most relevant clinical outcomes after acute ischemic stroke. Recently, a number of prognostic models of acute ischemic stroke have been developed, but they have not been extensively validated. In this study, we evaluated the ability of 3 prognostic models including the iScore, the PLAN score, and the ASTRAL score in predicting clinical poor outcomes or mortality at 6 months in patients with acute ischemic stroke.

Methods: A total of 323 patients were divided into a good-prognosis group and a poor-prognosis group based on the modified Rankin Scale. Model discrimination was quantified by calculating the area under the receiver operating characteristic (ROC) curve, and calibration was assessed by Hosmer-Lemeshow goodness of fit test and Pearson correlation coefficient.

Results: We identified 96 (29.7%) patients with poor prognosis, including 21 who were dead. All 3 models showed good ability in predicting poor prognosis and mortality in patients with acute ischemic stroke (all ROC > .70). There was no difference between these 3 models in terms of sensitivity and accuracy (all P > .05).

Conclusions: The results of this study suggest that the iScore, the PLAN score, and the ASTRAL score were equal in predicting 6-month poor prognosis and mortality in patients with acute ischemic stroke. Overall, there was a very high correlation between observed and expected outcomes at the risk score level.

Keywords: ASTRAL score; PLAN score; acute ischemic stroke; iScore; prognosis.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / mortality
  • Brain Ischemia / physiopathology
  • Decision Support Techniques*
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis*
  • Stroke / mortality
  • Stroke / physiopathology
  • Time Factors