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Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
Published on: February 22, 2020
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Prognostic rules for predicting cognitive syndromes following stroke: A systematic review
Bogna A Drozdowska1, Kris McGill1, Michael McKay2
1Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK.
European Stroke Journal
|April 5, 2021
Summary
Predicting cognitive syndromes after stroke is crucial. Current prognostic rules show promise but have high risk of bias and limited external validation, hindering clinical use.
Area of Science:
- Neurology
- Clinical Epidemiology
Background:
- Stroke survivors face a high risk of cognitive syndromes like delirium and dementia.
- Accurate prediction of post-stroke cognitive status is vital for timely diagnosis, intervention, and clinical trial stratification.
Purpose of the Study:
- To systematically identify, describe, and appraise existing multivariable prognostic rules for predicting cognitive syndromes post-stroke.
Main Methods:
- A systematic literature search was conducted across four databases up to November 2019.
- Data extraction and critical appraisal using the Prediction model Risk Of Bias Assessment Tool (PROBAST) were performed on included studies.
Main Results:
- Ten studies with 11 prognostic rules (7 for cognitive impairment, 4 for delirium) were included.
- Common predictors included demographics, imaging, stroke type, and severity. Predictive discrimination (AUROC) ranged from 0.80 to 0.91.
- All studies had a high risk of bias, and only one rule was externally validated.
Conclusions:
- The field of post-stroke cognitive outcome prediction is developing but requires improvement.
- High risk of bias and lack of external validation limit the current applicability of prognostic rules.
- Future research must adhere to best practice guidelines for prediction model development and validation.
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