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A simple scoring system for outcome prediction of ischemic stroke
Author(s) -
Muscari A.,
Puddu G. M.,
Santoro N.,
Zoli M.
Publication year - 2011
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2010.01479.x
Subject(s) - stroke (engine) , ischemic stroke , simple (philosophy) , outcome (game theory) , scoring system , medicine , physical medicine and rehabilitation , ischemia , mathematics , engineering , mechanical engineering , philosophy , epistemology , mathematical economics
Muscari A, Puddu GM, Santoro N, Zoli M. A simple scoring system for outcome prediction of ischemic stroke.
Acta Neurol Scand: 2011: 124: 334–342.
© 2011 John Wiley & Sons A/S. Objectives – According to most existing models, a computer is usually needed for predicting stroke outcome. Our purpose was to construct a simple and reliable prognostic scale not requiring the use of a calculating machine. Materials and Methods – The scale [the Bologna Outcome Algorithm for Stroke (BOAS)] was obtained in 221 patients with ischemic stroke not undergoing thrombolysis and was then validated in a test group of 100 different patients. Outcome was assessed at 9 months as the number of dependent or dead patients (modified Rankin scale – mRS > 2). Results – By a preliminary systematic univariate analysis, 25 of 415 baseline variables were found to be associated with a mRS > 2 independently of stroke severity and age. Subsequent multivariable analyses led to a final model based on five dichotomous risk factors (RF): National Institutes of Health Stroke Scale score ≥10, age ≥78, need of urinary catheter, oxygen administration, and persistence of upper limb paralysis at discharge from stroke unit. The patients with two or more RF (53%) had a mRS > 2 in 91% of cases and were dead in 42% of cases. With 0–1 RF, the two percentages were 24% and 2%, respectively (overall accuracy of prediction 83.9%, area under ROC curve [AUC] 0.891). In the test group, the accuracy was 79.0% and the AUC was 0.839. Conclusions – The need of urinary catheter, oxygen administration, and persistence of upper limb paralysis, together with stroke severity and advanced age, allow a simple and accurate prediction of dependency or death after ischemic stroke.