IScore:一种风险评分,用于预测急性缺血性中风住院后的早期死亡
Gustavo Saposnik1, Moira K Kapral, Ying Liu
1Stroke Outcomes Research Centre, Stroke Outcome Research Canada Working Group, Department of Medicine, St. Michael's Hospital, University of Toronto, 55 Queen St. E, Toronto, Ontario, Canada. saposnikg@smh.toronto.on.ca
Circulation
|February 9, 2011
概括
一个新的中风死亡风险评分识别了在医院抵达数小时内死亡的关键预测因素. 该工具帮助临床医生估计患者的风险,并比较医疗机构的表现.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 生物统计学 生物统计学
背景情况:
- 预测中风死亡率对于患者的护理和沟通至关重要.
- 在医院介绍时识别风险因素有助于早期干预.
研究的目的:
- 确定急性缺血性中风患者30天和1年死亡率的预测因素.
- 开发和验证一个风险评分模型,使用现有的医院数据.
主要方法:
- 从加拿大登记处 (2003-2008) 追溯分析了12,262名缺血性中风患者.
- 数据包括患者人口统计,中风特征和并发症.
- 多变量后勤回归和风险评分开发与内部和外部验证.
主要成果:
- 关键的死亡预测因素包括年龄,男性性别,中风严重程度,葡萄糖水平和并发症 (心房动,心力衰竭,癌症,痴呆症,脏疾病).
- 开发的风险评分显示出良好的预测准确性 (c-统计在0.782到0.851之间).
- 在验证队列中,30天后的死亡率为12.2-12.6%,1年后为22.5-22.9%.
结论:
- 早期在医院呈现时识别的因素有效预测缺血性中风死亡率.
- 经验证的风险评分可以帮助临床医生进行风险分层和政策制定者进行设施比较.
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