Shichao Sun1, Yuesong Pan2, Lei Bai3, Xingquan Zhao2, Liping Liu2, Hao Li2, Yilong Wang2, Li Guo4, Yongjun Wang5. 1. Department of Neurology, The Second Hospital, Hebei Medical University, Shi Jiazhuang, Hebei Province, China. 2. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China. 3. Department of Endocrinology, The Fourth Hospital, Hebei Medical University, Shi Jiazhuang, Hebei Province, China. 4. Department of Neurology, The Second Hospital, Hebei Medical University, Shi Jiazhuang, Hebei Province, China. Electronic address: guoli6hb@163.com. 5. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China. Electronic address: yongjunwang@ncrcnd.org.cn.
Abstract
BACKGROUND: We aimed to externally validate the Get With the Guidelines (GWTG) risk model for all stroke types to predict in-hospital stroke mortality in Chinese patients and moreover to explore its prognostic value in predicting 3-month mortality after stroke. METHODS: The prognostic model was applied to patients with acute stroke from China National Stroke Registry II (CNSR II) to predict in-hospital and 3-month mortality. Model discrimination was estimated by calculating c-statistic and 95% confidence intervals (CIs). Calibration was assessed by Pearson correlation coefficient and Hosmer-Lemeshow test. RESULTS: Date from 21,684 stroke patients with complete data for in-hospital mortality prediction and 20,348 stroke patients with complete data for 3-month mortality prediction in the CNSR II were abstracted. The in-hospital and 3-month mortality were 1.4% and 5.6%, respectively. The c-statistics in the CNSR II were .86 (95% CI, .84-.88) and .83 (95% CI, .81-.84) for in-hospital and 3-month mortality, respectively. Calibration plot presented high correlation between the observed and predicted mortality rates (Pearson correlation coefficient, .996 for in-hospital and .998 for 3-month mortality; both P < .001). The Hosmer-Lemeshow statistics for the prediction of in-hospital and 3-month mortality were 0.21 and less than .001, respectively. The model performed nearly as well in each stroke type as in the overall model including all types. CONCLUSIONS: The GWTG risk model for all stroke types is a valid clinical tool to predict in-hospital and 3-month mortality in Chinese patients with acute stroke of any type.
BACKGROUND: We aimed to externally validate the Get With the Guidelines (GWTG) risk model for all stroke types to predict in-hospital stroke mortality in Chinese patients and moreover to explore its prognostic value in predicting 3-month mortality after stroke. METHODS: The prognostic model was applied to patients with acute stroke from China National Stroke Registry II (CNSR II) to predict in-hospital and 3-month mortality. Model discrimination was estimated by calculating c-statistic and 95% confidence intervals (CIs). Calibration was assessed by Pearson correlation coefficient and Hosmer-Lemeshow test. RESULTS: Date from 21,684 strokepatients with complete data for in-hospital mortality prediction and 20,348 strokepatients with complete data for 3-month mortality prediction in the CNSR II were abstracted. The in-hospital and 3-month mortality were 1.4% and 5.6%, respectively. The c-statistics in the CNSR II were .86 (95% CI, .84-.88) and .83 (95% CI, .81-.84) for in-hospital and 3-month mortality, respectively. Calibration plot presented high correlation between the observed and predicted mortality rates (Pearson correlation coefficient, .996 for in-hospital and .998 for 3-month mortality; both P < .001). The Hosmer-Lemeshow statistics for the prediction of in-hospital and 3-month mortality were 0.21 and less than .001, respectively. The model performed nearly as well in each stroke type as in the overall model including all types. CONCLUSIONS: The GWTG risk model for all stroke types is a valid clinical tool to predict in-hospital and 3-month mortality in Chinese patients with acute stroke of any type.