Stroke Severity Is a Crucial Predictor of Outcome: An International Prospective Validation Study
Natalia S. Rost,Alex Bottle,Jin-Moo Lee,Marc Randall,S.E. Middleton,Louise Shaw,Vincent Thijs,Vincent Thijs,Gabriel J.E. Rinkel,Thomas M. Hemmen +9 more
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TLDR
In this prospective pilot study, the baseline NIHSS score was essential for prediction of acute ischemic stroke outcomes, followed by age; whereas traditional comorbidity index contributed little to the overall model.Abstract:
Background Stroke is among the leading causes of morbidity and mortality worldwide. Without reliable prediction models and outcome measurements, comparison of care systems is impossible. We analyzed prospectively collected data from 4 countries to explore the importance of stroke severity in outcome prediction.
Methods and Results For 2 months, all acute ischemic stroke patients from the hospitals participating in the Global Comparators Stroke GOAL (Global Outcomes Accelerated Learning) collaboration received a National Institutes of Health Stroke Scale (NIHSS) score on admission and a modified Rankin Scale score at 30 and 90 days. These data were added to the administrative data set, and risk prediction models including age, sex, comorbidity index, and NIHSS were derived for in‐hospital death within 7 days, all in‐hospital death, and death and good outcome at 30 and 90 days. The relative importance of each variable was assessed using the proportion of explained variation. Of 1034 admissions for acute ischemic stroke, 614 had a full set of NIHSS and both modified Rankin Scale values recorded; of these, 507 patients could be linked to administrative data. The marginal proportion of explained variation was 0.7% to 4.0% for comorbidity index, and 11.3 to 25.0 for NIHSS score. The percentage explained by the model varied by outcome (16.6–29.1%) and was highest for good outcome at 30 and 90 days. There was high agreement between 30‐ and 90‐day modified Rankin Scale scores (weighted κ=0.82).
Conclusions In this prospective pilot study, the baseline NIHSS score was essential for prediction of acute ischemic stroke outcomes, followed by age; whereas traditional comorbidity index contributed little to the overall model. Future studies of stroke outcomes between different care systems will benefit from including a baseline NIHSS score.read more
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Prediction of Outcome in Patients With Acute Ischemic Stroke Based on Initial Severity and Improvement in the First 24 h.
TL;DR: In this cohort, the prediction of GFO was improved by adding change in stroke severity after 24 h to the model, and B-NIHSS is a predictor of stroke outcome.
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Validity of a stroke severity index for administrative claims data research: a retrospective cohort study
Sheng-Feng Sung,Cheng Yang Hsieh,Huey Juan Lin,Yu Wei Chen,Chih Hung Chen,Yea Huei Kao Yang,Ya Han Hu +6 more
TL;DR: The SSI correlated with functional outcomes after AIS and improved the case-mix adjustment of mortality models and can act as a valid proxy for stroke severity in claims data-based studies.
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Social networks and neurological illness.
TL;DR: An agenda for research and clinical practice is proposed that includes mapping the networks of patients with diverse neurological disorders, evaluating the impact of the networks on patient outcomes, and testing network interventions.
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Biological Age is a predictor of mortality in Ischemic Stroke.
Carolina Soriano-Tárraga,Eva Giralt-Steinhauer,Marina Mola-Caminal,Angel Ois,Ana Rodríguez-Campello,Elisa Cuadrado-Godia,Israel Fernandez-Cadenas,Natalia Cullell,Jaume Roquer,Jordi Jimenez-Conde +9 more
TL;DR: As estimated by DNA methylation, biological age is an independent predictor of 3-month mortality in ischemic stroke regardless of chronological age, NIHSS, previous modified Rankin scale, and vascular risk factors.
Journal ArticleDOI
Biological age is better than chronological as predictor of 3-month outcome in ischemic stroke
Carolina Soriano-Tárraga,Carolina Soriano-Tárraga,Marina Mola-Caminal,Marina Mola-Caminal,Marina Mola-Caminal,Eva Giralt-Steinhauer,Eva Giralt-Steinhauer,Angel Ois,Angel Ois,Ana Rodríguez-Campello,Ana Rodríguez-Campello,Elisa Cuadrado-Godia,Elisa Cuadrado-Godia,Alejandra Gómez-González,Alejandra Gómez-González,Rosa Maria Vivanco-Hidalgo,Rosa Maria Vivanco-Hidalgo,Israel Fernandez-Cadenas,Israel Fernandez-Cadenas,Israel Fernandez-Cadenas,Natalia Cullell,Natalia Cullell,Natalia Cullell,Jaume Roquer,Jaume Roquer,Jordi Jimenez-Conde,Jordi Jimenez-Conde +26 more
TL;DR: B-age, estimated by DNA methylation, is an independent predictor of ischemic stroke outcome regardless of chronological years.
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