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Title: | Multicentric validation of a reduced features case-mix set for predicting functional outcome after ischemic stroke in Belgium | Authors: | Ordies, Sofie Lesenne, Anouk Bekelaar, Kim Demeestere, Jelle Lemmens , Robin Vanacker, Peter MESOTTEN, Dieter |
Issue Date: | 2022 | Publisher: | SPRINGER HEIDELBERG | Source: | ACTA NEUROLOGICA BELGICA, | Status: | Early view | Abstract: | Introduction Ischemic stroke is the second cause of death and leading cause of severe disability worldwide. A reduced features set of CT-DRAGON (age, NIHSS on admission and pre-stroke mRS) predicts 90-day functional outcome after stroke in a single center. The current study was designed to validate this adapted CT-DRAGON score in three major Belgian hospitals, in the framework of future case-mix adjustment. Methods This retrospective study included stroke patients, treated by thrombolysis, thrombectomy, a combination of both or neither thrombolysis or thrombectomy (conservative treatment) in 2019. Patient characteristics and 90-day mRS were collected. Multivariable logistic regression analysis of 90-day mRS 0-2 vs. 3-6 and 0-5 vs. 6 with the reduced features set was performed. Discriminative performance was assessed by the area under the receiver operating characteristic curve (AUROC). Results Thirty-three percent of patients (413/1243) underwent treatment. Majority of strokes was treated conservatively (n = 830, 67%), 18% (n = 225) was treated by thrombolysis, 7% (n = 88) by thrombectomy and 8% (n = 100) by thrombolysis and thrombectomy. Age, NIHSS and pre-stroke mRS were independently associated with 90-day mRS 0-2 (all p <= 0.0001, AUROC 0.88). When treatment modality was added in the model, age, NIHSS, pre-stroke mRS and treatment modality were independently associated with 90-day mRS 0-2 (p < 0.0001, p < 0.0001, p < 0.0001 and p = 0.0001) AUROC 0.89). Age, NIHSS, pre-stroke mRS and treatment modality were independently associated with 90-day survival (p = 0.0001, p < 0.0001, p < 0.0001 and p = 0.008, AUROC 0.86). Discussion The reduced features set (age, NIHSS and pre-mRS) was independently associated with long-term functional outcome in a Belgian multicentric cohort, making it useful for case-mix adjustments in Belgian stroke centers. Treatment modality was associated with long-term outcome. | Notes: | Mesotten, D (corresponding author), Ziekenhuis Oost Limburg Genk, Dept Anesthesiol Intens Care Med Emergency Med &, Genk, Belgium. dieter.mesotten@zol.be |
Keywords: | Ischemic cerebrovascular accident;stroke;prognosis | Document URI: | http://hdl.handle.net/1942/39076 | ISSN: | 0300-9009 | e-ISSN: | 2240-2993 | DOI: | 10.1007/s13760-022-02142-5 | ISI #: | 000886172400001 | Rights: | The Author(s) under exclusive licence to Belgian Neurological Society 2022 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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