External Validation of the iScore for Predicting Ischemic Stroke Mortality in Patients in China

Abstract

Details on the selection of variables for the iScore, data sources, and creation and conceptualization of the iScore have been published elsewhere. 7 The risk scoring system is presented in Table I in the online-only Data Supplement.Background and Purpose-The iScore is a prediction tool developed to estimate the risk of death in patients after hospitalization for an acute ischemic stroke. Our aim was to determine the accuracy of the iScore in patients with ischemic stroke in China. Methods-The iScore was used to predict 30-day mortality rate in 11 656 patients and 1-year mortality rate in 11 051 patients with acute ischemic stroke. These patients were identified from the China National Stroke Registry (CNSR) data set. Model discrimination was quantified by calculating the C statistic. The calibration was assessed using Pearson correlation coefficient. Results-The

Population-Based Validation of the iScore for Predicting Mortality and Early Functional Outcome in Ischemic Stroke Patients

“…Our results about the vital prognosis are in agreement with the two previous validation studies conducted on hospital-based cohorts, despite discrepancies in baseline characteristics of patients due to differences in settings [2,3]. Indeed, the mean age at onset was slightly higher in our study, as was the prevalence of all of the risk factors and comorbid conditions included in the calculation of the iScore except for renal dialysis and preadmission dependence.…”

“…The iScore system was recently derived from and internally validated by the Registry of the Canadian Stroke Network (RCSN), and subsequently validated externally in patients from both the Ontario Stroke Audit, and the China National Stroke Registry (CNSR) [2,3]. This easy-to-use score has been shown to reliably predict both 30-day and 1-year mortality in hospitalized ischemic stroke patients.…”

Predicting Functional Outcome and Symptomatic Intracranial Hemorrhage in Patients With Acute Ischemic Stroke

“…8 The ASTRAL score, the DRAGON score, the iScore, the Six Simple Variables score, and the Get With The Guidelines (GWTG) score have been extensively validated in external data sets and sometimes for the prediction of outcomes other than the ones for which they were originally developed. 69,70,[82][83][84][85][86][87][88][89][90][91][92][93][94][95] These extended validations further increase the scores' reliability. The scores that are free of specialized laboratory tests or imaging techniques and include only simple parameters are more feasible for centers with limited resources.…”

Validation of Stroke Prognostic Scores: What Do Clinicians Need to Know?

“…For example, the iScore was initially created and validated in an ethnically diverse population from Canada [8]. More recently, studies from Greece, Korea, China and other countries revealed good performance in other ethnic groups [16,17,18,19]. The present study provides some additional evidence of its application to a well-defined European population [11].…”