Performance of four ischemic stroke prognostic scores in a Brazilian population

Abstract

Objective Ischemic stroke (IS) prognostic scales may help clinicians in their clinical decisions. This study aimed to assess the performance of four IS prognostic scales in a Brazilian population. Method We evaluated data of IS patients admitted at Hospital Paulistano, a Joint Commission International certified primary stroke center. In-hospital mortality and modified Rankin score at discharge were defined as the outcome measures. The performance of National Institutes of Health Stroke Scale (NIHSS), Stroke Prognostication Using Age and NIHSS (SPAN-100), Acute Stroke Registry and Analysis of Lausanne (ASTRAL), and Totaled Health Risks in Vascular Events (THRIVE) were compared. Results Two hundred six patients with a mean ± SD age of 67.58 ± 15.5 years, being 55.3% male, were included. The four scales were significantly and independently associated functional outcome. Only THRIVE was associated with in-hospital mortality. With area under the curve THRIVE and NIHSS were the scales with better performance for functional outcome and THRIVE had the best performance for mortality. Conclusion THRIVE showed the best performance among the four scales, being the only associated with in-hospital mortality.

Thinking About the Future: A Review of Prognostic Scales Used in Acute Stroke

“…The ASTRAL scale has been subsequently externally validated by seven studies, with six assessing predictive value based on AUROC estimates (42–48). Within these, ASTRAL was found to have fair to good discriminatory power, with the exception of one study, involving a Brazilian cohort (AUROC 0.67) (44). These external validation studies used differing time points for outcome assessment (up to 5 years post-stroke) and differing outcomes, including mortality and symptomatic intracerebral hemorrhage (sICH).…”

“…There have been 16 subsequent studies externally validating THRIVE. These involved patient groups receiving intra-arterial therapy, intravenous thrombolysis, and no acute treatments, and focused on a number of different outcomes – good functional outcome, poor outcome, risk of hemorrhagic transformations, infarct size, and even pulmonary infection (44, 118–132). The majority of studies aimed to predict multiple outcomes, and 15 assessed the scales predictive performance in terms of AUROC values, typically alongside other estimates.…”

Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study

“…[9] The independent prognostic role of stress hyperglycemia in acute stroke is yet to be deciphered. Totaled Health Risks in Vascular Events (THRIVE) score (totaled health risks in vascular events) calculated with age, NIHSS, and the presence of hypertension, diabetes mellitus, and atrial fibrillation proved to be a significant mortality predictor in acute ischemic stroke in previous studies [ 10 ] but sufficient data are lacking. Thus, we planned our study to assess the different prognostic variables including stress hyperglycemia and THRIVE score and their impact on the outcome in acute stroke patients.…”

Fatores De Risco E Características Sociodemográficas Do Avc Isquêmico No Brasil – Revisão Sistemática

“…O AVC, normalmente resultante dos fatores elencados anteriormente, além da mortalidade, pode gerar sequelas que não impactam somente o âmbito individual, como também o social e econômico. Estas sequelas afetam a produtividade e autonomia do indivíduo, podendo ser descritas e observadas pelos principais sinais e sintomas como paresia, dor, déficits visuais e atenuação motora(KUSTER et al, 2016). Science Direct (Elsevier) e Embase.A busca nas bases de dados foi realizada utilizando às terminologias cadastradas nos Descritores em Ciências da Saúde criados pela Biblioteca Virtual em Saúde desenvolvido a partir do Medical Subject Headings da U.S. National Library of Medicine, que permite o uso da terminologia comum em português, inglês e espanhol.…”