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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Prognostic indices for early mortality in ischaemic stroke - meta-analysis
K Mattishent1, C S Kwok1, A Mahtani1
1Norwich Medical School, University of East Anglia, Norwich, UK.
Acta Neurologica Scandinavica
|May 14, 2015
Summary
This study systematically reviewed prognostic scores for ischaemic stroke mortality. The iSCORE demonstrated strong predictive accuracy across multiple countries, showing the broadest evidence base among evaluated tools.
Area of Science:
- Neurology
- Clinical Epidemiology
- Biostatistics
Background:
- Predicting mortality in ischaemic stroke is crucial for patient management.
- Numerous prognostic models exist, but their comparative performance requires systematic evaluation.
Purpose of the Study:
- To systematically evaluate the performance of published stroke prognostic scores for predicting early mortality after ischaemic stroke.
Main Methods:
- Systematic literature search of MEDLINE and EMBASE (2003-2014) for prognostic models.
- Meta-analysis of area under the curve receiver operating characteristic curve (AUROC) to assess discriminant ability.
- Evaluation of study validity components including data collection and missing data handling.
Main Results:
- 18 articles involving 163,240 patients were analyzed.
- The iSCORE showed good performance with a pooled AUROC of 0.84 and had the most validation cohorts.
- Other tools like SOAR, GWTG, and PLAN showed potential but required further validation.
Conclusions:
- Several prognostic scores offer modest to good predictive accuracy for early mortality in ischaemic stroke.
- The iSCORE stands out due to its extensive validation and consistent performance across diverse populations.
- Further validation of other promising tools is warranted to expand options for clinical use.
