在大血管塞治疗后,HERMES-24的得分导出和验证为简单而稳健的结果预测
Koji Tanaka1, Scott Brown2, Mayank Goyal1,3
1Department of Clinical Neurosciences (K.T., M.G., B.K.M., M.N., M.D.H., A.M.D.), Cumming School of Medicine, University of Calgary, AB, Canada.
Stroke
|July 22, 2024
概括
一个新的HERMES-24评分预测了治疗后24小时急性缺血性中风患者的结果. 这种简单的,经过验证的得分有助于对前部循环大血管阻塞中风的预后讨论.
科学领域:
- 神经学 神经学
- 临床决策 - 临床决策
- 脑卒中医学 脑卒中医学
背景情况:
- 临床医生需要简单的,可预测的预后得分,用于急性缺血性中风管理.
- 制定这样的分数有助于在治疗后24小时的实际决策.
研究的目的:
- 开发和验证90天功能结果的简单预后得分 (修改的兰金表 ≤2).
- 评分是针对前部循环急性缺血性中风的患者,治疗时或没有进行内血管血栓切除术.
主要方法:
- 使用HERMES协作数据集 (n=1764) 与导出 (n=430) 和验证 (n=441) 队列.
- 逻辑回归确定了预测因素:国家卫生研究院中风量表24小时和年龄的得分.
- 在控制臂和外部队列 (ESCAPE-NA1,INTERRSeCT) 中验证了衍生的HERMES-24得分.
主要成果:
- 在HERMES-24得分 (年龄/10+NIHSS在24小时) 显示高预测准确度 (c-统计 0.907-0.914) 跨队伍.
- 该得分有效地分层风险:得分≥25的良好结果概率低 (mRS ≤2),得分<10.0的概率高.
- 在ESCAPE-NA1和INTERRSeCT的外部验证证实了预测性表现 (c-统计数据为0.894和0.889).
结论:
- 治疗后的HERMES-24评分是一个简单的,经过验证的工具,用于预测前部循环大血管闭塞中风的3个月后结果.
- 它适用于不论治疗 (内血管血栓切除术或不).
- 该得分有助于在早期 (2日) 与家庭进行预后讨论.
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