Show simple item record

A risk score for in-hospital death in patients admitted with ischemic or hemorrhagic stroke.

dc.contributor.author Dai, D
dc.contributor.author Fonarow, GC
dc.contributor.author Hernandez, Adrian Felipe
dc.contributor.author Olson, DaiWai M
dc.contributor.author Peterson, Eric David
dc.contributor.author Reeves, MJ
dc.contributor.author Saver, JL
dc.contributor.author Schwamm, LH
dc.contributor.author Shobha, N
dc.contributor.author Smith, EE
dc.coverage.spatial England
dc.date.accessioned 2017-07-06T16:00:23Z
dc.date.available 2017-07-06T16:00:23Z
dc.date.issued 2013-01-28
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/23525444
dc.identifier 2/1/e005207
dc.identifier.uri https://hdl.handle.net/10161/15019
dc.description.abstract BACKGROUND: We aimed to derive and validate a single risk score for predicting death from ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). METHODS AND RESULTS: Data from 333 865 stroke patients (IS, 82.4%; ICH, 11.2%; SAH, 2.6%; uncertain type, 3.8%) in the Get With The Guidelines-Stroke database were used. In-hospital mortality varied greatly according to stroke type (IS, 5.5%; ICH, 27.2%; SAH, 25.1%; unknown type, 6.0%; P<0.001). The patients were randomly divided into derivation (60%) and validation (40%) samples. Logistic regression was used to determine the independent predictors of mortality and to assign point scores for a prediction model in the overall population and in the subset with the National Institutes of Health Stroke Scale (NIHSS) recorded (37.1%). The c statistic, a measure of how well the models discriminate the risk of death, was 0.78 in the overall validation sample and 0.86 in the model including NIHSS. The model with NIHSS performed nearly as well in each stroke type as in the overall model including all types (c statistics for IS alone, 0.85; for ICH alone, 0.83; for SAH alone, 0.83; uncertain type alone, 0.86). The calibration of the model was excellent, as demonstrated by plots of observed versus predicted mortality. CONCLUSIONS: A single prediction score for all stroke types can be used to predict risk of in-hospital death following stroke admission. Incorporation of NIHSS information substantially improves this predictive accuracy.
dc.language eng
dc.relation.ispartof J Am Heart Assoc
dc.relation.isversionof 10.1161/JAHA.112.005207
dc.subject Aged
dc.subject Aged, 80 and over
dc.subject Brain Ischemia
dc.subject Cerebral Hemorrhage
dc.subject Chi-Square Distribution
dc.subject Decision Support Techniques
dc.subject Female
dc.subject Hospital Mortality
dc.subject Humans
dc.subject Inpatients
dc.subject Logistic Models
dc.subject Male
dc.subject Middle Aged
dc.subject Multivariate Analysis
dc.subject Predictive Value of Tests
dc.subject Registries
dc.subject Reproducibility of Results
dc.subject Risk Assessment
dc.subject Risk Factors
dc.subject Severity of Illness Index
dc.subject Stroke
dc.subject Subarachnoid Hemorrhage
dc.subject United States
dc.title A risk score for in-hospital death in patients admitted with ischemic or hemorrhagic stroke.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/23525444
pubs.begin-page e005207
pubs.issue 1
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 2
dc.identifier.eissn 2047-9980


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record