- 作者：Tai Hwan Park ; Sang-Soon Park ; Youngchai Ko ; Soo Joo Lee ; Kyung Bok Lee ; Jun Lee ; Kyusik Kang ; Jong-Moo Park ; Jay Chol Choi ; Dong-Eog Kim ; Yong-Jin Cho ; Keun-Sik Hong ; Joon-Tae Kim ; Dae-Hyun Kim ; Jae-Kwan Cha ; Moon-Ku Han ; Ji Sung Lee ; Juneyoung Lee ; Kyung-Ho Yu ; Byung-Chul Lee ; Byung-Woo Yoon ; et al.
- 关键词：Risk score ; prediction ; thrombolysis ; ischemic stroke
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：February, 2014
- 年：2014
- 卷：23
- 期：2
- 页码：367-373
- 全文大小：348 K
Background
Despite substantial differences in clinical features between Asian and Western stroke patients, there are no published prognostic tools validated in an Asiatic population for thrombolytic therapy. We assessed the ability of the iScore to predict the clinical response after intravenous thrombolysis with tissue plasminogen activator (tPA) in a Korean stroke population.Methods
We applied the iScore to eligible participants in the nationwide multicenter stroke registry in Korea. Main outcome measures were poor functional outcome defined as having a modified Rankin Scale score 3-6 and death at 3聽months. Symptomatic intracranial hemorrhage (sICH) was evaluated as a safety outcome. C statistic was calculated to assess performance of iScore.
Results
Among 4760 patients with an acute ischemic stroke, 622 (13.1%) received tPA, 548 patients had complete information for the analysis. C statistics for poor functional outcome and death at 3聽months were .813 (95% confidence interval [CI]: .778-.848) and .820 (95% CI: .769-.872), respectively. Overall, there was a high correlation between observed and expected outcome for poor functional outcome (Pearson correlation coefficient, r = .982) and for death at 3聽months (r = .950) at the risk score level. An iScore of 180 or more was associated with a more than 2 times risk of poor functional outcome and about 6 times risk of death at 3聽months. There was an interaction between the iScore and tPA for a poor functional outcome (P聽value for the interaction < .001). We found a gradient effect in the incident risk of sICH with the iScore.
Conclusion
The iScore reliably predicts stroke outcomes after tPA聽in Asiatic population.