External Validation of the Totaled Health Risks in Vascular Events Score to Predict Functional Outcome and Mortality in Patients Entered into the China National Stroke Registry

Weiqi Chen, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Gaifen Liu, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Jiming Fang, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Yilong Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Yanli Song, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Yuesong Pan, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Hao Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Liping Liu, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Chunxue Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
David Zheng Wang, Department of Neurology, Illinois Neurological Institute Stroke Network, OSF Healthcare Systems, University of Illinois College of Medicine at Peoria, Peoria, Illinois.Follow
Xingquan Zhao, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China. Electronic address: yongjunwang1962@gmail.com.

Document Type

Article

Abstract

BACKGROUND: THRIVE (Totaled Health Risks in Vascular Events) score is a tool used to predict the functional outcome and mortality in patients with ischemic stroke at 3 months. This project aims to explore its prognostic value at 3, 6, and 12 months in Chinese stroke patients. METHODS: We applied the THRIVE score in 11,064 patients with acute ischemic stroke who were entered into the China National Stroke Registry. We applied the THRIVE score and examined its performance on mortality and poor functional outcome (modified Rankin Scale score between 3 and 6). Model discrimination was measured by c-statistic. Calibration was assessed by comparing predicted and observed probability of poor outcome or mortality by using Pearson correlation coefficient. RESULTS: Among the 11,064 patients with ischemic stroke, the mortality rates at discharge, and at 3, 6, and 12 months were 3.6%, 7.9%, 10.5%, and 12.7%, respectively; the corresponding c-statistics were .83(95% confidence interval [CI], .80-.86), .79(95% CI, .77-.81), .80(95% CI, .78-.81), and .79(95% CI, .78-.80), respectively. For the poor functional outcome at discharge, and at 3, 6, and 12 months, the c-statistics were .74(95% CI, .73-.75), .76(95% CI, .75-.77), .76(95% CI, .75-.77), and .77(95% CI, .76-.78), respectively. The observed and expected probability of poor functional outcome and mortality based on the THRIVE score correlated (Pearson correlation coefficient ranged from .90 to .99) highly. CONCLUSIONS: The THRIVE score is a reliable tool to predict the mortality and to fairly predict the functional outcome at discharge, and at 3, 6, and 12 months in Chinese patients after acute ischemic stroke.

Medical Subject Headings

Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Area Under Curve; Brain Ischemia (diagnosis, mortality, physiopathology, therapy); Child; China; Comorbidity; Decision Support Techniques; Disability Evaluation; Female; Hospital Mortality; Humans; Male; Middle Aged; Patient Discharge; Predictive Value of Tests; ROC Curve; Recovery of Function; Registries; Reproducibility of Results; Risk Assessment; Risk Factors; Stroke (diagnosis, mortality, physiopathology, therapy); Time Factors; Treatment Outcome; Young Adult

Publication Date

10-1-2016

Publication Title

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

E-ISSN

1532-8511

Volume

25

Issue

10

First Page

2331

Last Page

7

PubMed ID

27544868

Digital Object Identifier (DOI)

10.1016/j.jstrokecerebrovasdis.2016.03.021

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