Risk prediction of very early recurrence, death and progression after acute ischaemic stroke

Maier, Ilko; Bauerle, Michael; Kermer, Pawel; Helms, Hans‐Joachim; Buettner, Thomas

doi:10.1111/ene.12037

Cited by 31 publications

(26 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[8,9] The frequency of neurological deterioration in this singlecenter study was 15.4%, which was higher than that of a retrospective study which assessed deteriorations within the first two days [10] and lower than those of two prospective studies (35% and 37%, respectively). [11,12] The studies for early neurological deterioration in non- thrombolyzed patients were found to have frequencies between 13 to 37% [13][14][15][16][17] Our patients with neurological progression had worse NIHSS scores on discharge, compared to non-progressive patients (8 vs 3.7), while the NIHSS scores were not different on admission between these two groups.…”

Section: Discussioncontrasting

confidence: 66%

Progression in acute ischemic stroke: Is widespread atherosclerotic background a risk factor?

Sumer

Özön

2017

Turk J Phys Med Rehab

View full text Add to dashboard Cite

Objectives:In this study, we aimed to investigate the causes and conditions related with progression and outcome of progressive acute ischemic stroke. Patients and methods:In this prospective study, a total of 78 acute ischemic stroke patients (32 males, 46 females; mean age 70±12.8 years; range 34 to 95 years) were included between February 2006 and October 2010. The patients were classified into two groups as those with and without progression according to the National Institute of Health Stroke Scale (NIHSS). Risk factors for ischemic stroke, stroke subtypes, and radiological investigations and prognosis were compared between the progressive and non-progressive patients.Results: Neurological deterioration occurred in 12 patients (15%). Progressive acute ischemic stroke patients had carotid stenosis compared to non-progressive patients (50% vs 19%), and ischemic cardiac disease (33% vs 6%) more common in the patients with progression. Mortality during hospital stay and long term-outcomes were similar between the groups. Conclusion:Our study results suggest that widespread atherosclerotic diseases may induce neurological progression.

show abstract

Section: Discussioncontrasting

confidence: 66%

Progression in acute ischemic stroke: Is widespread atherosclerotic background a risk factor?

Sumer

Özön

2017

Turk J Phys Med Rehab

View full text Add to dashboard Cite

show abstract

“…These findings were robust to sensitivity analyses [see Additional file 1]. One evaluation study for the RRE-90 score estimated an AUROCC of 0.72 (95% CI 0.64 to 0.80) [52] and another of the LiLAC score estimated an AUROCC of 0.65 (95% CI 0.61 to 0.70) [50]. We identified two evaluations of the ABCD2 score [48,52,53].…”

Section: Resultsmentioning

confidence: 64%

“…We identified four additional evaluations among the model development studies [30,37,39,41] giving fifteen evaluation cohorts: five evaluations of the ESRS [29,37,43-45]; three of the SPI-II [41,46,47]; five head-to-head comparisons of the ESRS and the SPI-II [30,39,48-51]; one head-to-head comparison of the ESRS and the RRE-90 [52]; and one comparing the ESRS, the SPI-II and the LiLAC models [50]. …”

Section: Resultsmentioning

confidence: 99%

“…One evaluation study for the RRE-90 score estimated an AUROCC of 0.72 (95% CI 0.64 to 0.80) [52] and another of the LiLAC score estimated an AUROCC of 0.65 (95% CI 0.61 to 0.70) [50]. We identified two evaluations of the ABCD2 score [48,52,53]. Although the ABCD2 score was developed and designed for patients with TIA (and, therefore, did not meet our inclusion criteria) its performance was similar to other clinical prediction models for recurrent stroke (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Formal and informal prediction of recurrent stroke and myocardial infarction after stroke: a systematic review and evaluation of clinical prediction models in a new cohort

Thompson

Murray

Dennis

et al. 2014

BMC Med

View full text Add to dashboard Cite

BackgroundThe objective of this study was to: (1) systematically review the reporting and methods used in the development of clinical prediction models for recurrent stroke or myocardial infarction (MI) after ischemic stroke; (2) to meta-analyze their external performance; and (3) to compare clinical prediction models to informal clinicians’ prediction in the Edinburgh Stroke Study (ESS).MethodsWe searched Medline, EMBASE, reference lists and forward citations of relevant articles from 1980 to 19 April 2013. We included articles which developed multivariable clinical prediction models for the prediction of recurrent stroke and/or MI following ischemic stroke. We extracted information to assess aspects of model development as well as metrics of performance to determine predictive ability. Model quality was assessed against a pre-defined set of criteria. We used random-effects meta-analysis to pool performance metrics.ResultsWe identified twelve model development studies and eleven evaluation studies. Investigators often did not report effective sample size, regression coefficients, handling of missing data; typically categorized continuous predictors; and used data dependent methods to build models. A meta-analysis of the area under the receiver operating characteristic curve (AUROCC) was possible for the Essen Stroke Risk Score (ESRS) and for the Stroke Prognosis Instrument II (SPI-II); the pooled AUROCCs were 0.60 (95% CI 0.59 to 0.62) and 0.62 (95% CI 0.60 to 0.64), respectively. An evaluation among minor stroke patients in the ESS demonstrated that clinicians discriminated poorly between those with and those without recurrent events and that this was similar to clinical prediction models.ConclusionsThe available models for recurrent stroke discriminate poorly between patients with and without a recurrent stroke or MI after stroke. Models had a similar discrimination to informal clinicians' predictions. Formal prediction may be improved by addressing commonly encountered methodological problems.

show abstract

“…The third International Stroke Trial (IST-3) showed some benefit in selected patients within 6 hours from symptom onset and demonstrated benefit in elderly patients over 80 years of age (previously excluded from treatment) and those with severe stroke. 23 Owing to a significant risk of early recurrence of stroke (>3%), 24 all patients should start aspirin of 100 to 300 mg immediately after the diagnosis cardiac causes, and lipid abnormalities), thus together accounting for 90% of strokes. Those 10 modifiable risk factors contribute the most to stroke risk and should be targeted in clinical practice.…”

mentioning

confidence: 99%

Prevention of ischemic stroke in clinical practice: a role of internists and general practitioners

Niewada¹,

Członkowska²

2014

Polish Archives of Internal Medicine

View full text Add to dashboard Cite

Risk prediction of very early recurrence, death and progression after acute ischaemic stroke

Cited by 31 publications

References 35 publications

Progression in acute ischemic stroke: Is widespread atherosclerotic background a risk factor?

Progression in acute ischemic stroke: Is widespread atherosclerotic background a risk factor?

Formal and informal prediction of recurrent stroke and myocardial infarction after stroke: a systematic review and evaluation of clinical prediction models in a new cohort

Prevention of ischemic stroke in clinical practice: a role of internists and general practitioners

Contact Info

Product

Resources

About