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BMC Neurology

, 13:121

Cerebrovascular disease and stroke

Abstract

BackgroundDiabetes constitutes a risk factor for stroke that also aggravates stroke prognosis. Several prognostic models have been developed for the evaluation of neurologic status, severity, short-term functional outcome and mortality of stroke patients. IScore is a novel tool recently developed in order to predict mortality rates within 30 days and 1 year after ischemic stroke and diabetes is not included in the scoring scale of IScore. The aim of the present study was to evaluate and compare IScore validity in ischemic stroke patients with and without diabetes.

MethodsThis prospective study included 312 consecutive Caucasian patients with type 2 diabetes and 222 Caucasian patients without diabetes admitted for ischemic stroke in a tertiary Greek hospital. Thirty-day and 1-year IScores were individually calculated for each patient and actual mortality was monitored at the same time intervals. IScore’s predictive ability and calibration was evaluated and compared for ischemic stroke patients with and without diabetes. The performance of IScore for predicting 30 and 1-year mortality between patients with and without diabetes was assessed by determining the calibration and discrimination of the score. The area under the receiver operating characteristic curve was used to evaluate the discriminative ability of IScore for patients with and without diabetes, whereas the calibration of IScore was assessed by the Hosmer–Lemeshow goodness-of fit statistic.

ResultsBaseline population characteristics and mortality rates did not differ significantly for both cohorts. IScore values were significantly higher for patients with diabetes at 30 days and 1 year after ischemic stroke and patients with diabetes presented more frequently with lacunar strokes. Based on ROC curves analysis IScore’s predictive ability for 30 day mortality was excellent, without statistically significant difference, for both cohorts. Predictive ability for 1 year mortality was also excellent for both groups with significantly better ability for patients with diabetes especially at high score values. Calibration of the model was good for both groups of patients.

ConclusionsIScore accurately predicts mortality in acute ischemic stroke Caucasian patients with and without diabetes with higher efficacy in predicting 1 year mortality in patients with diabetes especially with high scores.

KeywordsIScore Stroke Ischemic stroke Ischemic stroke mortality Diabetes AbbreviationsISIschemic stroke

CTComputed tomography

TOASTTrial of ORG 10172 in acute stroke treatment

CADCoronary artery disease

CHFCongestive heart failure

ROC curvesReceiver operating characteristic curves

AUCArea under the curves

CNSCanadian neurological scale

MIMyocardial infarction.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-13-121 contains supplementary material, which is available to authorized users.

Vasileios Dragoumanos, Konstantinos N Tzirogiannis contributed equally to this work.

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Autor: Vasileios Dragoumanos - Konstantinos N Tzirogiannis - Georgios I Panoutsopoulos - Konstantinos Krikonis - Evangelos Fouster

Fuente: https://link.springer.com/



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