国家神经系统疾病临床医学研究中心数据管理与共享系统

发表杂志：Stroke

发表类型: Article

影响因子(IF): 7.914

PMID: 33588598 Pubmed原文链接 全文下载

Minor ischemic stroke with a low NIHSS is common with around 1 million new minor stroke every year in China and often leads to disabling events[1]. Previous study in 174 minor stroke or transient ischemic stroke (TIA) patients showed that the stroke recurrence rate in minor stroke was 11.5% within 1 week[2]. Large-scale registries found that the 1-year and 5-year stroke recurrence rates were around 6-6.4% [3, 4]. Definitions of minor stroke vary from studies. The NIHSS was utilized as the most common evaluation scale for determining the severity of stroke. Minor stoke was commonly defined as (1) NIHSS ≤5 [3-7], (2) NIHSS≤3 [8, 9] and (3) NIHSS ≤2 [10] in previously studies. Whether the clinical characteristics and in-hospital outcomes of minor stroke across different definitions had significant differences are not well investigated. The China Stroke Center Alliance[11] is a national-wide prospective registry with more than 1 million stroke patients, the NIHSS, detailed clinical characteristics and in-hospital outcomes were collected which allows us to investigate the differences of clinical characteristics and in-hospital outcomes based on different criteria for minor stroke. It is the largest sample size study, which will help cross comparisons for minor stroke studies, and decision making for target patients in future clinical trials.

Objective: To compare the clinical characteristics and outcomes of minor stroke by different definitions and find out the best cut-off of minor stroke for predicting in-hospital outcomes. Hypothesis: We hypothesized that the composite outcome rate of in-hospital mortality and in-hospital recurrent stroke (ischemic stroke and hemorrhagic stroke) and in-hospital myocardial infarction of minor stroke using NIHSS ≤5 would be significantly higher than that of minor stroke using NIHSS ≤3 and that of minor stroke using NIHSS ≤2, while these latter two groups might have similar composite events rates. Data sources: China Stroke Center Alliance (CSCA) Population: Inclusion: over 18, acute ischemic stroke, patients with NIHSS ≤5 Intervention/exposure: Minor stroke with (1) NIHSS ≤5 [5, 6], (2) NIHSS≤3 [8] and (3) NIHSS ≤2 [10] Statistical analysis Continuous variables will be expressed as mean± SD for normally distributed date and median (interquartile range) for skewed data. Categorical variables will be expressed as number (percentage). For categorical data, chi-square tests were used to test the differences among the NIHSS≤5, NIHSS≤3, NIHSS≤2 groups. For age groups in 10 years interval, a line curve will be constructed to show the trend of rate of composite outcome of in-hospital mortality, in-hospital recurrent stroke (ischemic stroke+hemorrhagic stroke) and in-hospital myocardial infarction in NIHSS≤5, NIHSS≤3, NIHSS≤2 groups. ROC curve will be used to determine the best cut-offs of NIHSS for composite outcome of in-hospital mortality, in-hospital recurrent stroke (ischemic stroke+hemorrhagic stroke) and in-hospital myocardial infarction, and in-hospital mortality, in-hospital recurrent ischemic stroke, respectively.