An integer-based score to predict functional outcome in acute ischemic stroke: The ASTRAL score.

Details

Ressource 1Request a copy Sous embargo indéterminé.
State: Public
Version: author
Serval ID
serval:BIB_CD4F5F0DDE8C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
An integer-based score to predict functional outcome in acute ischemic stroke: The ASTRAL score.
Journal
Neurology
Author(s)
Ntaios G., Faouzi M., Ferrari J., Lang W., Vemmos K., Michel P.
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
78
Number
24
Pages
1916-1922
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish Author contributions: Dr. Ntaios: study concept and design, analysis and interpretation, preparation of the manuscript. Dr. Faouzi: analysis and interpretation, critical revision of the manuscript for important intellectual content. Dr. Ferrari: acquisition of data, critical revision of the manuscript for important intellectual content. Prof. Lang: acquisition of data, critical revision of the manuscript for important intellectual content. Dr. Vemmos: acquisition of data, critical revision of the manuscript for important intellectual content. Dr. Michel: study concept and design, analysis and interpretation, critical revision of the manuscript for important intellectual content, study supervision.
Abstract
OBJECTIVE: To develop and validate a simple, integer-based score to predict functional outcome in acute ischemic stroke (AIS) using variables readily available after emergency room admission.
METHODS: Logistic regression was performed in the derivation cohort of previously independent patients with AIS (Acute Stroke Registry and Analysis of Lausanne [ASTRAL]) to identify predictors of unfavorable outcome (3-month modified Rankin Scale score >2). An integer-based point-scoring system for each covariate of the fitted multivariate model was generated by their β-coefficients; the overall score was calculated as the sum of the weighted scores. The model was validated internally using a 2-fold cross-validation technique and externally in 2 independent cohorts (Athens and Vienna Stroke Registries).
RESULTS: Age (A), severity of stroke (S) measured by admission NIH Stroke Scale score, stroke onset to admission time (T), range of visual fields (R), acute glucose (A), and level of consciousness (L) were identified as independent predictors of unfavorable outcome in 1,645 patients in ASTRAL. Their β-coefficients were multiplied by 4 and rounded to the closest integer to generate the score. The area under the receiver operating characteristic curve (AUC) of the score in the ASTRAL cohort was 0.850. The score was well calibrated in the derivation (p = 0.43) and validation cohorts (0.22 [Athens, n = 1,659] and 0.49 [Vienna, n = 653]). AUCs were 0.937 (Athens), 0.771 (Vienna), and 0.902 (when pooled). An ASTRAL score of 31 indicates a 50% likelihood of unfavorable outcome.
CONCLUSIONS: The ASTRAL score is a simple integer-based score to predict functional outcome using 6 readily available items at hospital admission. It performed well in double external validation and may be a useful tool for clinical practice and stroke research.
Pubmed
Web of science
Create date
23/07/2012 10:47
Last modification date
20/08/2019 16:47
Usage data