Haifeng Mao1, Qianyi Wu2, Peiyi Lin3, Junrong Mo4, Huilin Jiang5, Shaopeng Lin6, Timothy H Rainer7, Xiaohui Chen8. 1. Emergency Department, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: maomao2010x@163.com. 2. Institute of Neuroscience and Department of Neurology, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: wuqianyi0608@163.com. 3. Emergency Department, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: linpeiyi@163.com. 4. Emergency Department, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: junrongmo@163.com. 5. Emergency Department, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: lifisher@126.com. 6. Emergency Department, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: linsp@qq.com. 7. Institute of Molecular and Experimental Medicine, Welsh Heart Research Institute, Cardiff University School of Medicine, Cardiff, UK. Electronic address: RainerTH@cardiff.ac.uk. 8. Emergency Department, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: cxhgz168paper@163.com.
Abstract
BACKGROUND: Efficient assessment of patients after ischemic stroke has important reference value for doctors to choose appropriate treatment for patients. Our study aimed to develop a new prognostic model for predicting outcomes 3 months after ischemic stroke among Chinese Population. METHODS: A prospective observational cohort study among ischemic stroke patients presenting to Emergency Department in the Second Affiliated Hospital of Guangzhou Medical University was conducted from May 2012 to June 2013. Demographic data of ischemic stroke patients, assessment of NIHSS and laboratory results were collected. Based on 3-month modified Rankin Scale (mRS) ischemic stroke patients were divided into either favorable outcome (mRS: 0-2) or unfavorable outcome groups (mRS: 3-6). The variables closely associated with prognosis of ischemic stroke were selected to develop the new prognostic model (NAAP) consisted of 4 parameters: NIHSS, age, atrial fibrillation, and prealbumin. The prognostic value of the modified prognostic model was then compared with NIHSS alone. RESULTS: A total of 454 patients with suspected stroke were recruited. One hundred eighty-six patients with ischemic stroke were included in the final analysis. A new prognostic model, NAAP was developed. The area under curve (AUC) of NAAP was .861 (95%confidence interval: .803-.907), whilst the AUC of NIHSS was .783 (95%CI: .717-.840), (P = .0048). Decision curve analysis showed that NAAP had a higher net benefit for threshold probabilities of 65% for predictive risk of poor outcomes. CONCLUSIONS: The modified prognostic model, NAAP may be a better prognostic tool for predicting 3-month unfavorable outcomes for ischemic stroke than NIHSS alone.
BACKGROUND: Efficient assessment of patients after ischemic stroke has important reference value for doctors to choose appropriate treatment for patients. Our study aimed to develop a new prognostic model for predicting outcomes 3 months after ischemic stroke among Chinese Population. METHODS: A prospective observational cohort study among ischemic strokepatients presenting to Emergency Department in the Second Affiliated Hospital of Guangzhou Medical University was conducted from May 2012 to June 2013. Demographic data of ischemic strokepatients, assessment of NIHSS and laboratory results were collected. Based on 3-month modified Rankin Scale (mRS) ischemic strokepatients were divided into either favorable outcome (mRS: 0-2) or unfavorable outcome groups (mRS: 3-6). The variables closely associated with prognosis of ischemic stroke were selected to develop the new prognostic model (NAAP) consisted of 4 parameters: NIHSS, age, atrial fibrillation, and prealbumin. The prognostic value of the modified prognostic model was then compared with NIHSS alone. RESULTS: A total of 454 patients with suspected stroke were recruited. One hundred eighty-six patients with ischemic stroke were included in the final analysis. A new prognostic model, NAAP was developed. The area under curve (AUC) of NAAP was .861 (95%confidence interval: .803-.907), whilst the AUC of NIHSS was .783 (95%CI: .717-.840), (P = .0048). Decision curve analysis showed that NAAP had a higher net benefit for threshold probabilities of 65% for predictive risk of poor outcomes. CONCLUSIONS: The modified prognostic model, NAAP may be a better prognostic tool for predicting 3-month unfavorable outcomes for ischemic stroke than NIHSS alone.