Abstract 3621: Predicting 90 Day Outcome in Acute Ischemic Stroke Patients
Background and Purpose- Predictive scales for outcome in intracerebral hemorrhage patients have been used to provide prognostic information on mortality. Valid and reliable scales do not exist for acute ischemic stroke patients. The purpose of this study was to create a statistically valid model on which to predict 90 day functional outcome in acute ischemic stroke patients.
Methods- This was a retrospective analysis of prospectively collected data on acute ischemic stroke patients. A univariate logistic regression analysis was done to assess for independent predictor variables. Any variable with a p<0.15 at the univariate level was included in a stepwise logistic regression model and appropriate interaction effects were tested. A model was constructed to predict 90 day stroke outcome. Good outcome was defined as mRS 0-2 and bad outcome was defined as mRS 3-6 at 90 days.
Results- 569 patients were included in the analysis. Age ranged from 21-98 (mean 70), baseline NIHSS 0-40 (median 6), 48% of patients were treated with rt-PA (n=277), 10% were black (n=57), and 15% were Hispanic (n=89). In univariate analysis, independent predictors of outcome were age (p<0.0001), weight (p=0.0003), baseline NIHSS (p<0.0001), diastolic blood pressure (p=0.02), treatment with rt-PA (p<0.0001), history of hypertension (p=0.0009), history of CAD/MI (p=0.002), history of stroke (p=0.02), current smoker (p=0.02), and history of atrial fibrillation (p=0.0001). Ethnicity (p=0.09) was included in the model. On stepwise linear regression, age (p<0.001, β-0.03), baseline NIHSS (p<0.001, β -0.15), Hispanic ethnicity (p=0.02, β -0.66) remained as independent predictors of 90 day outcome.
Conclusions- A prognostic scale for acute ischemic stroke patient outcome would be clinically useful. This analysis based on sound statistical procedures can serve as a basis for the creation of a valid and reliable scale for predicting 90 day outcome in acute ischemic stroke patients. A scoring system is currently being developed for testing.
- © 2012 by American Heart Association, Inc.