A Dynamic Model for Predicting Survival up to 1 Year After Ischemic Stroke

J Stroke Cerebrovasc Dis. 2020 Oct;29(10):105133. doi: 10.1016/j.jstrokecerebrovasdis.2020.105133. Epub 2020 Jul 18.

Abstract

Background: This study developed and validated a dynamic prediction model for survival after ischaemic stroke up to 1 year.

Methods: Patients with stroke (n = 425) who participated in a sub-study (2002-2004) from the South London Stroke Register (SLSR) were selected for model derivation. The model was developed using the extended Cox model with time-dependent covariates. The two temporal validation cohorts from SLSR included 1735 (1995-2002) and 2155 patients (2004-2016). The discrimination, calibration and clinical utility of the model were assessed.

Results: Six strong predictors were used in the model, namely, age, sex, stroke subtype, stroke severity and pre-stroke and post-stroke disabilities. The c-statistics was 0.822 at 1 year in the derivation cohort. The model had a fair performance with prognostic accuracies of 77%-83% in the validation 1 cohort and 70%-75% in the validation 2 cohort. A good calibration was observed in the derivation cohort.

Conclusion: The proposed model can accurately predict survival up to 1 year after ischaemic stroke.

Keywords: Clinical prediction; Mortality; Prognosis; Stroke.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / mortality
  • Brain Ischemia / therapy
  • Decision Support Techniques*
  • Female
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Registries
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis*
  • Stroke / mortality
  • Stroke / therapy
  • Time Factors
  • Young Adult