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：Journal of Stroke and Cerebrovascular Diseases

发表类型: Original Contributions

影响因子(IF): 1.646

PMID: 25194739 Pubmed原文链接 全文下载

Stroke Prognostication using Age and NIH (National Institutes of Health) Stroke Scale (SPAN)-100 is a simple and easy-to-use tool for assessing the outcomes of ischemic stroke after thrombolysis. To explore its application, we eval- uated SPAN-100’s prognostic value in predicting 3- and 12-month outcomes in gen- eral ischemic stroke patients. Methods: We applied the SPAN-100 to ischemic stroke patients from the China National Stroke Registry. Poor outcome was defined as a modified Rankin Scale of 2-6. Discrimination of SPAN-100 was assessed by the area under the receiver–operator curves (AUC) and 95% confidence intervals (CI). We also performed an exploratory post hoc analysis of the performance of the SPAN index score using 80 as the cutoff point. Results: Among 11,894 ischemic stroke patients, 479 (4.0%) patients were SPAN-100 positive. The AUC of SPAN- 100 for poor outcome was .54 (95% CI, .54-.54) at 3 months and .54 (95% CI, .54- .55) at 12 months, respectively. In the exploratory analysis, when 80 was used as the cutoff point of SPAN index score, the AUC for poor outcome was .66 (95% CI, .66-.67) at 3 months and .68 (95% CI, .67-.68) at 12 months, respectively. Conclusions: SPAN-100 suffered from low prediction power for 3- and 12-month outcomes of ischemic stroke in Chinese population. A cutoff point of 80 may improve the perfor- mance, but none of them had an AUC above the threshold of .8 required for use in individuals. Key Words: SPAN-100—ischemic stroke—outcome—prognosis. 。 2014 by National Stroke Association

Data were derived from CNSR,5 a nationwide prospec- tive registry of 21,902 consecutive patients with a diagnosis of ischemic stroke, intracerebral hemorrhage, or transient ischemic attack from 132 hospitals in China between September 2007 and August 2008. Data on demographics, clinical characteristics, and outcomes at the 3, 6, 12 months follow-up visits were collected. The collection of data for the CNSR study was approved by ethics committees at all participating hospitals. Written informed consent was obtained from all patients or their legal representatives. At 3 and 12 months after onset of stroke, the outcomes of all patients were assessed through telephone follow-up interview. The telephone follow-up was centralized for all included patients and based on a shared standardized interview protocol. Favorable outcome was defined as a modified Rankin Scale (mRS) of 0-1 and poor outcome was defined as mRS of 2-6 according to the original deriva- tion study of SPAN-100 score.1 SPAN index was calculated as age in years plus NIHSS on admission.1 According to the derivation study, patients with a SPAN index score $100 were defined as SPAN-100 positive, whereas those with a score ,100 were defined as SPAN-100 negative.1 We also performed an exploratory post hoc analysis using 80 as the cutoff point. Patients with a SPAN index score $80 were designated as SPAN-80 positive and those with a score ,80 were designated as SPAN-80 negative. Patients with missing data of SPAN index score or 12- month mRS were excluded from this analysis.