A prognostic index for 30-day mortality after stroke

Abstract

The objective of this study was to develop a simplified scoring system to predict 30-day mortality in patients with acute ischemic stroke. A retrospective cohort study was performed in a tertiary referral hospital in the Hunter Region of Australia. A prognostic index was created by assigning points to the variables in a Cox model. The index included impaired consciousness (5 points), dysphagia (3 points), urinary incontinence (4 points), admission body temperature higher than 36.5 degrees C (2 points), and hyperglycemia without a clinical history of diabetes (2 points). A score of 11 or more defined a high-risk group. The index achieved a sensitivity, specificity, and positive predictive value of 68%, 98% and 75%, respectively, in the derivation sample and 57%, 97% and 68%, respectively, in the validation sample. The results provide a simple risk stratification instrument for clinical research and practice. Further evaluation of the model in a prospective cohort is warranted