This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Williams, G. R. Articles by Jiang, J. G. Search for Related Content PubMed PubMed Citation Articles by Williams, G. R. Articles by Jiang, J. G. Related Collections Behavioral/psychosocial - stroke Acute Cerebral Infarction Behavioral Changes and Stroke Rehabilitation, Stroke

(Stroke. 2000;31:2414.)
© 2000 American Heart Association, Inc.

Original Contributions

Development of an Ischemic Stroke Survival Score

G. Rhys Williams, MS, ScD John G. Jiang, PhD

From the Department of Health Economics and Reimbursement, Knoll Pharmaceutical Company, Mount Olive, NJ (G.R.W., J.G.J.), and Department of Epidemiology and Biostatistics, School of Public Health, Boston University (Mass) (G.R.W.).

Background and Purpose—There has been substantial interest in identifying predictors of survival for stroke patients. Current instruments used for measuring stroke severity are confined to either neurological, functional, or disability measures. The purpose of this study was to develop a stroke survival score that combines instruments from different domains to better predict long-term survival.

Methods—We took advantage of a particularly broad array of clinical and physiological variables collected during the Stroke Treatment with Ancrod Trial. Four hundred fifty-three patients completed a battery of instruments at day 7 after stroke and then were followed for 1 year.

Results—Of the 453 patients, 53% were male, 77% were aged 65 years or older, and 89% were white. One hundred nine patients (24%) died during the study period. Age was a highly significant predictor of mortality (P<0.001), but there were no statistically significant differences in 12-month survival with respect to sex, race, or educational level. The best model for predicting survival was the Ischemic Stroke Survival Score. This model included the Scandinavian Stroke Scale, Rapid Disability Rating Scale, age, and prior stroke. This model had substantially greater predictive power (R²=0.30, c statistic=0.86) than the Scandinavian Stroke Scale alone (R²=0.20, c statistic=0.78).

Conclusions—This study demonstrates that combining day 7 poststroke information from multiple domains substantially improves the ability to predict 12-month survival of ischemic stroke patients compared with data from a single domain. The high mortality rate emphasizes the importance of preventive measures for a disease that has identifiable and modifiable risk factors.

Key Words: clinical trials • outcome assessment • prognosis • stroke, acute • survival

This article has been cited by other articles:

				D. M. Bravata, S.-Y. Ho, L. M. Brass, J. Concato, J. Scinto, and T. P. Meehan Long-Term Mortality in Cerebrovascular Disease Stroke, March 1, 2003; 34(3): 699 - 704. [Abstract] [Full Text] [PDF]