on April 10, 2008
Published online before print April 10, 2008, doi: 10.1161/STROKEAHA.107.505867
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on September 30, 2007
From the Institut für Medizinische Biometrie und Statistik (I.R.K., A.Z.), Universität zu Lübeck, Lübeck, Germany; Boehringer Ingelheim (E.B.), Ingelheim am Rhein, Germany; Neurologische Klinik (W.H.), Universität Heidelberg, Heidelberg, Germany; Stroke Trials Unit (P.M.W.B.), Division of Stroke Medicine, University of Nottingham, Nottingham, England; Miller School of Medicine (R.L.S.), University of Miami, Miami, Fla; and Klinik für Neurologie (H.C.D., C.W.), Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany. * To whom correspondence should be addressed. E-mail: inke.koenig{at}imbs.uni-luebeck.de.
Background and Purpose—An early and reliable prognosis for recovery in stroke patients is important for initiation of individual treatment and for informing patients and relatives. We recently developed and validated models for predicting survival and functional independence within 3 months after acute stroke, based on age and the National Institutes of Health Stroke Scale score assessed within 6 hours after stroke. Herein we demonstrate the applicability of our models in an independent sample of patients from controlled clinical trials. Methods—The prognostic models were used to predict survival and functional recovery in 5419 patients from the Virtual International Stroke Trials Archive (VISTA). Furthermore, we tried to improve the accuracy by adapting intercepts and estimating new model parameters. Results—The original models were able to correctly classify 70.4% (survival) and 72.9% (functional recovery) of patients. Because the prediction was slightly pessimistic for patients in the controlled trials, adapting the intercept improved the accuracy to 74.8% (survival) and 74.0% (functional recovery). Novel estimation of parameters, however, yielded no relevant further improvement. Conclusions—For acute ischemic stroke patients included in controlled trials, our easy-to-apply prognostic models based on age and National Institutes of Health Stroke Scale score correctly predicted survival and functional recovery after 3 months. Furthermore, a simple adaptation helps to adjust for a different prognosis and is recommended if a large data set is available.
Revised on October 22, 2007
Accepted on October 24, 2007
Predicting Long-Term Outcome After Acute Ischemic Stroke. A Simple Index Works in Patients From Controlled Clinical Trials
Inke R. König PhD*;
Key words: stroke • outcome • National Institutes of Health Stroke Scale • prediction • clinical trials
Related Article:
Stroke 2008 39: 1665-1666.
This article has been cited by other articles:
 |
|
 |
|
  P. Khatri, T. Abruzzo, S. D. Yeatts, C. Nichols, J. P. Broderick, T. A. Tomsick, and For the IMS I and II Investigators Good clinical outcome after ischemic stroke with successful revascularization is time-dependent Neurology, September 29, 2009; 73(13): 1066 - 1072. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Putaala, S. Curtze, S. Hiltunen, H. Tolppanen, M. Kaste, and T. Tatlisumak Causes of Death and Predictors of 5-Year Mortality in Young Adults After First-Ever Ischemic Stroke: The Helsinki Young Stroke Registry Stroke, August 1, 2009; 40(8): 2698 - 2703. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Beebe and C. E. Lang Active Range of Motion Predicts Upper Extremity Function 3 Months After Stroke Stroke, May 1, 2009; 40(5): 1772 - 1779. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. G. Rudd and L. S. Williams Advances in Health Policy and Outcomes Stroke, May 1, 2009; 40(5): e301 - e304. [Full Text] [PDF]
|
|
|
|
|
|
M. Dennis Predictions Models in Acute Stroke: Potential Uses and Limitations Stroke, June 1, 2008; 39(6): 1665 - 1666. [Full Text] [PDF]
|
|