Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
external validation of a case-mix adjustment model for the standardized reporting of 30 day stroke mortality rates in China
First author：Ping Yu
Corresponding author：Li Guo,Yilong Wang
essential_information
2016-11-15
Published articles
Journal：PLOS ONE
Publication type: Original Contributions
IF(IF): 3.24
PMID: 27846282 Link To Pubmed Full text Download
Background And Purpose
A case-mix adjustment model has been developed and externally validated, demonstrating promise. However, the model has not been thoroughly tested among populations in China. In our study, we evaluated the performance of the model in Chinese patients with acute stroke.
Method
The case-mix adjustment model A includes items on age, presence of atrial fibrillation on admission, National Institutes of Health Stroke Severity Scale (NIHSS) score on admission, and stroke type. Model B is similar to Model A but includes only the consciousness component of the NIHSS score. Both model A and B were evaluated to predict 30-day mortality rates in 13,948 patients with acute stroke from the China National Stroke Registry. The discrimination of the models was quantified by c-statistic. Calibration was assessed using Pearson's correlation coefficient.
Conclusion
The case-mix adjustment model could be used to effectively predict 30-day mortality rates in Chinese patients with acute stroke.
Main results
The c-statistic of model A in our external validation cohort was 0.80 (95% confidence interval, 0.79±0.82), and the c-statistic of model B was 0.82 (95% confidence interval, 0.81± 0.84). Excellent calibration was reported in the two models with Pearson's correlation coefficient (0.892 for model A, p<0.001; 0.927 for model B, p = 0.008). PLOS