External Validation of the Totaled Health Risks in Vascular Events Score to Predict Functional Outcome and Mortality in Patients Entered into the China National Stroke Registry

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• 作者：Weiqi Chen ; MD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; ¹ ; Gaifen Liu ; PhD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; ¹ ; Jiming Fang ; PhD^‖ ; Yilong Wang ; MD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; Yanli Song ; MD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; Yuesong Pan ; PhD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; Hao Li ; PhD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; Liping Liu ; MD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; Chunxue Wang ; MD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; David Zheng Wang ; DO^¶ ; ; Xingquan Zhao ; MD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; Yongjun Wang ; MD^* ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; ^{yongjunwang1962@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; on behalf of the China National Stroke Registry (CNSR) Investigators
• 关键词：China National Stroke Registry ; ischemic stroke ; prognosis ; THRIVE score
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：25
• 期：10
• 页码：2331-2337
• 全文大小：985 K

文摘

THRIVE (Totaled Health Risks in Vascular Events) score is a tool used to predict the functional outcome and mortality in patients with ischemic stroke at 3 months. This project aims to explore its prognostic value at 3, 6, and 12 months in Chinese stroke patients.

Methods

We applied the THRIVE score in 11,064 patients with acute ischemic stroke who were entered into the China National Stroke Registry. We applied the THRIVE score and examined its performance on mortality and poor functional outcome (modified Rankin Scale score between 3 and 6). Model discrimination was measured by c-statistic. Calibration was assessed by comparing predicted and observed probability of poor outcome or mortality by using Pearson correlation coefficient.

Results

Among the 11,064 patients with ischemic stroke, the mortality rates at discharge, and at 3, 6, and 12 months were 3.6%, 7.9%, 10.5%, and 12.7%, respectively; the corresponding c-statistics were .83(95% confidence interval [CI], .80-.86), .79(95% CI, .77-.81), .80(95% CI, .78-.81), and .79(95% CI, .78-.80), respectively. For the poor functional outcome at discharge, and at 3, 6, and 12 months, the c-statistics were .74(95% CI, .73-.75), .76(95% CI, .75-.77), .76(95% CI, .75-.77), and .77(95% CI, .76-.78), respectively. The observed and expected probability of poor functional outcome and mortality based on the THRIVE score correlated (Pearson correlation coefficient ranged from .90 to .99) highly.

Conclusions

The THRIVE score is a reliable tool to predict the mortality and to fairly predict the functional outcome at discharge, and at 3, 6, and 12 months in Chinese patients after acute ischemic stroke.