External Validation of the Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) Score for Predicting Stroke-Associated Pneumonia in the Athens Stroke Registry
Ημερομηνία
2015Γλώσσα
en
Λέξη-κλειδί
Επιτομή
Background and purpose The Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score was developed recently for predicting stroke-associated pneumonia (SAP), one of the most common complications after stroke. The aim of the present study was to externally validate the ISAN score. Methods Data included in the Athens Stroke Registry between June 1992 and December 2011 were used for this analysis. Inclusion criteria were the availability of all ISAN score variables (prestroke independence, sex, age, National Institutes of Health Stroke Scale score). Receiver operating characteristic curves and linear regression analyses were used to determine the discriminatory power of the score and to assess the correlation between actual and predicted pneumonia in the study population. Separate analyses were performed for patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). Results The analysis included 3204 patients (AIS: 2732, ICH: 472). The ISAN score demonstrated excellent discrimination in patients with AIS (area under the curve [AUC]:.83 [95% confidence interval {CI}:.81-.85]). In the ICH group, the score was less effective (AUC:.69 [95% CI:.63-.74]). Higher-risk groups of ISAN score were associated with an increased relative risk of SAP; risk increase was more prominent in the AIS population. Predicted pneumonia correlated very well with actual pneumonia (AIS group: R2=.885; β-coefficient=.941, P<.001; ICH group: R2=.880, β-coefficient=.938, P<.001). Conclusions In our external validation in the Athens Stroke Registry cohort, the ISAN score predicted SAP very accurately in AIS patients and demonstrated good discriminatory power in the ICH group. Further validation and assessment of clinical usefulness would strengthen the score's utility further. © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Collections
Related items
Showing items related by title, author, creator and subject.
-
Characteristics and Outcomes in Patients with COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry
Ntaios G., Michel P., Georgiopoulos G., Guo Y., Li W., Xiong J., Calleja P., Ostos F., González-Ortega G., Fuentes B., Alonso De Leciñana M., Díez-Tejedor E., García-Madrona S., Masjuan J., Defelipe A., Turc G., Gonçalves B., Domigo V., Dan G.-A., Vezeteu R., Christensen H., Christensen L.M., Meden P., Hajdarevic L., Rodriguez-Lopez A., Díaz-Otero F., García-Pastor A., Gil-Nuñez A., Maslias E., Strambo D., Werring D.J., Chandratheva A., Benjamin L., Simister R., Perry R., Beyrouti R., Jabbour P., Sweid A., Tjoumakaris S., Cuadrado-Godia E., Campello A.R., Roquer J., Moreira T., Mazya M.V., Bandini F., Matz K., Iversen H.K., González-Duarte A., Tiu C., Ferrari J., Vosko M.R., Salzer H.J.F., Lamprecht B., Dünser M.W., Cereda C.W., Quintero Á.B.C., Korompoki E., Soriano-Navarro E., Soto-Ramírez L.E., Castañeda-Méndez P.F., Bay-Sansores D., Arauz A., Cano-Nigenda V., Kristoffersen E.S., Tiainen M., Strbian D., Putaala J., Lip G.Y.H. (2020)Recent case-series of small size implied a pathophysiological association between coronavirus disease 2019 (COVID-19) and severe large-vessel acute ischemic stroke. Given that severe strokes are typically associated with ... -
Prophylactic antibiotic treatment in severe acute ischemic stroke: the Antimicrobial chemopRrophylaxis for Ischemic STrokE In MaceDonIa–Thrace Study (ARISTEIDIS)
Tziomalos K., Ntaios G., Miyakis S., Papanas N., Xanthis A., Agapakis D., Milionis H., Savopoulos C., Maltezos E., Hatzitolios A.I. (2016)Infections represent a leading cause of mortality in patients with acute ischemic stroke, but it is unclear whether prophylactic antibiotic treatment improves the outcome. We aimed to evaluate the effects of this treatment ... -
Early gastrostomy reduces the rate of ventilator-associated pneumonia in stroke or head injury patients
Kostadima, E.; Kaditis, A. G.; Alexopoulos, E. I.; Zakynthinos, E.; Sfyras, D. (2005)Presence of a nasogastric tube is a risk factor for the development of ventilator-associated pneumonia (VAP). Alternatively, gastrostomy can be used for administration of enteral feedings. To determine whether early ...