4.7 Article

Predicting functional outcome after stroke by modelling baseline clinical and CT variables

Journal

AGE AND AGEING
Volume 39, Issue 3, Pages 360-366

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/ageing/afq027

Keywords

acute stroke; elderly; outcomes; prognosis

Funding

  1. Capital Health Research Fund
  2. Nova Scotia Health Research Foundation
  3. Dalhousie Internal Medicine Research Foundation
  4. Merck Frosst
  5. Hoffman-La Roche
  6. Chest Heart and Stroke Scotland [Res07/A108] Funding Source: researchfish

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Methods: 538 consecutive acute ischaemic and haemorrhagic stroke patients were enrolled in a Stroke Outcome Study between 2001 and 2002. Independent survival (modified Rankin scale < 2) was assessed at 6 months. Models based on clinical and radiological variables from the first assessment were developed using multivariate logistic regression analysis. Results: three models were developed (I-III). Model I included age, pre-stroke independence, arm power and a stroke severity score (area under a receiver operating characteristic curve, AUC = 0.882) but performed no better than Model II, which comprised age, pre-stroke independence, normal verbal component of the Glasgow coma score, arm power and being able to walk without assistance (AUC 0.876). Model III, including two radiological variables and clinical variables, was not statistically superior to model II (AUC 0.901, P = 0.12). Model II was externally validated in two independent datasets (AUCs of 0.773 and 0.787). Conclusion: this study demonstrates an externally validated stroke outcome prediction model using simple clinical variables. Outcome prediction was not significantly improved with CT-derived radiological variables or more complex clinical variables.

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