Poor performance of stroke prognostication using Age and National Institutes of Health Stroke Scale-100 to predict 3- and 12-month outcomes of ischemic stroke in China National Stroke Registry.
BACKGROUND: Stroke Prognostication using Age and NIH (National Institutes of Health) Stroke Scale (SPAN)-100 is a simple and easy-to-use tool for assessing the outcomes of ischemic stroke after thrombolysis. To explore its application, we evaluated SPAN-100's prognostic value in predicting 3- and 12-month outcomes in general ischemic stroke patients. METHODS: We applied the SPAN-100 to ischemic stroke patients from the China National Stroke Registry. Poor outcome was defined as a modified Rankin Scale of 2-6. Discrimination of SPAN-100 was assessed by the area under the receiver-operator curves (AUC) and 95% confidence intervals (CI). We also performed an exploratory post hoc analysis of the performance of the SPAN index score using 80 as the cutoff point. RESULTS: Among 11,894 ischemic stroke patients, 479 (4.0%) patients were SPAN-100 positive. The AUC of SPAN-100 for poor outcome was .54 (95% CI, .54-.54) at 3 months and .54 (95% CI, .54-.55) at 12 months, respectively. In the exploratory analysis, when 80 was used as the cutoff point of SPAN index score, the AUC for poor outcome was .66 (95% CI, .66-.67) at 3 months and .68 (95% CI, .67-.68) at 12 months, respectively. CONCLUSIONS: SPAN-100 suffered from low prediction power for 3- and 12-month outcomes of ischemic stroke in Chinese population. A cutoff point of 80 may improve the performance, but none of them had an AUC above the threshold of .8 required for use in individuals.
Pan, Y; Jing, J; Zhang, R; Zhao, X; Liu, L; Wang, H; Liu, G; Wang, C; Wang, Y; Wang, Y
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