文章摘要
应用重庆卒中评分预测腔隙性卒中患者短期不良预后风险
External Validation of the Chongqing Stroke Scale to Predict Short Term Functional Outcomes after Lacunar Stroke.
投稿时间:2022-06-05  修订日期:2022-06-05
DOI:
中文关键词: 腔隙性卒中  早期神经功能缺损进展  预后  受试者工作特征曲线
英文关键词: Lacunar stroke  early neurological deterioration  prognosis  ROC
基金项目:
作者单位E-mail
金迪 航天中心医院 jindi721@163.com 
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中文摘要:
      目的:探讨重庆卒中评分(Chongqing stroke scale,CQSS)对腔隙性卒中(lacunar stroke,LS)患者的短期不良预后及早期神经功能缺损进展(early neurological deterioration,END)的预测价值。方法:前瞻性纳入2020年6月1日至2021年5月31日期间在航天中心医院神经内科住院的294名腔隙性脑梗死患者,记录患者基线资料,并进行CQSS评分,主要结局事件为出院时不良预后(改良Rankin评分≥3分),次要结局事件为出现END,通过受试者工作特征曲线下面积(AUC)判断CQSS对结局事件的预测价值。结果:294名患者中包含预后不良组58人,对照组236人,预后不良组的首次NIHSS评分、首次CQSS评分、CQSS评分增幅均高于对照组,且首次CQSS评分和NIHSS评分之间存在显著的相关性(Pearson系数=0.914,P<0.001)。CQSS对LS患者在出院时存在不良预后的风险具有较好的预测意义(AUC=0.760,95%CI 0.692-0.829,P<0.001),截断值为5分。CQSS评分对于出现END事件的预测准确度较低(AUC=0.613,95%CI 0.538-0.689,P=0.007)。结论:CQSS评分对LS患者短期不良结局发生风险预测价值较高,评分越高出现不良预后的风险越大,对于发生END的风险预测价值一般,需要进一步研究探讨以提高对END事件的预测效能。
英文摘要:
      Objective: We assessed the efficacy of the Chongqing stroke scale (CQSS), which designed for predicting short term outcome risk and early neurological deterioration (END) after stroke, in lacunar stroke (LS) patients. Methods: From June 2020 to May 2021, we collected 294 LS patients who hospitalized in neurology department of Aerospace Center Hospital prospectively. Related baseline data were recorded and calculated by the CQSS. The main outcome events were defined as poor functional outcome at discharge (modified Rankin scale no less than 3 points) after the index stroke event. The secondary outcome events were defined as END. Model discrimination was quantified by calculating the area under the Receiver Operating Characteristic curve (AUC). Results: The number of patients who had and without unfavorable outcome at discharge was 58 and 236, respectively. The initial NIHSS score, initial CQSS score, and the increase of CQSS score in the poor prognosis group were higher than those in the control group, and there was a significant correlation between the first CQSS score and the NIHSS score (Pearson coefficient=0.914, P<0.001). CQSS had good predictive value for the risk of poor prognosis in LS patients at discharge (AUC=0.760, 95%CI 0.692-0.829, P<0.001), with a cut-off value of 5 points. It was less accurate in predicting END events (AUC=0.613, 95%CI 0.538-0.689, P=0.007). Conclusion: The CQSS score has nice predictive value for the risk of short-term adverse outcomes in LS patients. The higher the score, the greater the risk of poor prognosis. Predictive value for the risk of END is moderate. Further research is needed to improve the predictive performance of END events.
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