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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Multivariate Prognostic Model of Acute Stroke Combining Admission Infarct Location and Symptom Severity: A Proof-of-Concept Study
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Multivariate Prognostic Model of Acute Stroke Combining Admission Infarct Location and Symptom Severity: A Proof-of-Concept Study

机译：急性中风的多变量预后模型结合入院梗死位置及症状严重程度：概念验证研究

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Background: The information on topographic distribution of acute ischemic infarct can contribute to prediction of functional outcome. We aimed to develop a multivariate model for stroke prognostication, combining admission clinical and imaging variables, including the infarct topology. Methods: Acute ischemic stroke patients without baseline functional disability who had magnetic resonance imaging within 24 hours of onset or last-seen-well were included. The admission stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS) score. The relation between infarct location and outcome was assessed using both voxel-based and visual atlas-based analyses. The disability/death was defined by a modified Rankin Scale score greater than 2 at 3-month follow-up. Results: Among 198 patients included in this study, higher admission NIHSS score (P .001), larger infarct volume (P .001), and major arterial occlusions (P .001) were associated with disability/death in univariate analyses. On voxel-based analysis, infarcts in the middle centrum semiovale, insula, and midbrain/pons were associated with higher rates of disability/death. In multivariate analysis, admission NIHSS score (P .001), infarction of insula (P = .005), and midbrain/pons (P = .006) were independent predictors of disability/death. In receiver operating characteristics analysis, a simple 0-to-3 scoring system using these 3 variables had an area under the curve of .812 for prediction of disability/death (P .001). Conclusions: Admission symptom severity, infarction of insula, and midbrain/pons were independent predictors of clinical outcome in acute ischemic stroke patients. The methodology of this hypothesis-generating study can help conceive quantitative population-based probabilistic models for prognostication or treatment triage in stroke patients, combining admission clinical and imaging findings-including infarct topography.
机译：背景：关于急性缺血性梗塞的地形分布的信息可以有助于预测功能结果。我们旨在为中风预测开发多元模型，结合入场临床和成像变量，包括梗塞拓扑。方法：急性缺血性卒中患者没有基线功能残疾，患者在发病或上一孔的24小时内具有磁共振成像。使用国立卫生冲程量表（NIHSS）得分确定入学冲程严重程度。使用基于Voxel的和基于Visual Atlas的分析评估梗塞位置和结果之间的关系。残疾/死亡是由3个月随访时间大于2的修改规模得分定义。结果：198名患者包括在本研究中，进入NIHSS得分更高（P＆ .001），较大的梗塞体积（P＆ .001）和主要动脉闭合（P＆ .001）与残疾/死亡有关在单变量分析中。在基于体素的分析中，中间中心半动物，insula和中脑/ PON中的梗塞与较高的残疾/死亡率相关。在多变量分析中，入院NIHSS得分（P＆ .001），肠道梗塞（p = .005）和中脑/ PON（p = .006）是残疾/死亡的独立预测因子。在接收器操作特性分析中，使用这3个变量的简单0至3评分系统在.812的曲线下具有一个区域，用于预测残疾/死亡（P <.001）。结论：入院症状严重程度，肠内梗塞和中脑/ PONS是急性缺血性卒中患者临床结果的独立预测因子。该假设产生研究的方法可以有助于在中风患者中构思的预后或治疗分类是基于定量的群体概率模型，结合入院临床和成像结果 - 包括梗塞地形。

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