Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
External validation of the prestroke independence, sex, age, national institutes of health stroke scale score for predicting pneumonia after stroke using data from the china national stroke registry.
First author：Runhua Zhang
Corresponding author：Yongjun Wang,Yilong Wang
essential_information
- Person in charge：Runhua Zhang
- Data Sources： CNSR-I
- Number of papers：CNSR-I20190042
- Published time：2017-05-01
2017-05-01
Published articles
Journal：Journal of Stroke and Cerebrovascular Diseases
Publication type: Original Contributions
IF(IF): 1.598
PMID: 27988203 Link To Pubmed Full text Download
Background And Purpose
Pneumonia is an important risk factor for mortality and morbidity after stroke. The Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score was shown to be a useful tool for predicting stroke-associated pneumonia based on UK multicenter cohort study. We aimed to externally validate the score using data from the China National Stroke Registry (CNSR).
Method
Eligible patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) in the CNSR from 2007 to 2008 were included. The area under the receiver operating characteristic (AUC) curve was used to evaluate discrimination. The Hosmer–Lemeshow goodness of fit test and Pearson correlation coefficient were performed to assess calibration of the model.
Conclusion
The ISAN score was a useful tool for predicting in-hospital pneumonia after acute stroke, especially for patients with AIS. Further validations need to be done in different populations.
Main results
A total of 19,333 patients (AIS = 14400; ICH = 4933) were included and the overall pneumonia rate was 12.7%. The AUC was .76 (95% confidence interval [CI]: .75-.78) for the subgroup of AIS and .70 (95% CI: .68-.72) for the subgroup of ICH. The Hosmer-Lemeshow test showed the ISAN score with the good calibration for AIS and ICH (P = .177 and .405, respectively). The plot of observed versus predicted pneumonia rates suggested higher correlation for patients with AIS than with ICH (Pearson correlation coefficient = .99 and .83, respectively).