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Risikoprädiktion für sehr frühen Reinfarkt, Tod und Progression nach ischämischem Schlaganfall

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

Ilko Maier
Doctoral thesis
Date of Examination: 2014-01-20
Date of issue: 2013-12-20
Advisor: Kermer, Pawel Prof. Dr.
Referee: Kermer, Pawel Prof. Dr.
Referee: Hilgers, Reinhard Prof. Dr.
Referee: Mausberg, Rainer Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-0022-60A6-F

 

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Abstract

English

Background: Early recurrent strokes lead to extended hospitalization and high number of complications. We investigated three stroke scores, the Essen Stroke Risk Score, the ABCD² and the Recurrence Risk Estimator for their prognostic value to predict early recurrent stroke, death and progressive stroke. Methods: Clinical and radiological data from 1727 consecutive patients with ischemic stroke, being admitted to the stroke unit, were evaluated retrospectively. Predictive value of stroke scores was tested for early recurrence within 7 days, death and progressive stroke expressed as observational risk and area under the receiver operator curve (AUROC). Results: Early recurrent stroke occurred in 56 patients (3.2%), 40 patients (2.3%) died within the first 7 days and 125 patients (7.2%) had a progressive stroke. Essen Stroke Risk Score was not predictive for early recurrence, death or progressive stroke. ABCD² score was predictive for death (p<0.01; χ²; AUROC, 0.65; 0.58 to 0.72), and progressive stroke (p<0.001; χ²; AUROC, 0.70; 0.66 to 0.74). Recurrence Risk Estimator predicted early recurrent stroke (p<0.001; χ²; AUROC, 0.65; 0.58 to 0.73), early death (p<0.001; χ²; AUROC, 0.72; 0.66 to 0.78) and progressive stroke (p<0.001; χ²; AUROC, 0.66; 0.61 to 0.71). Conclusions: Recurrence Risk Estimator bears high potential to not only predict early recurrence but also death and progression after ischemic stroke. ABCD² appears to be useful to predict risk of death and progression. These findings have relevant clinical implications for early triage of patients being admitted to stroke units.
Keywords: Early recurrence; Ischemic stroke; Essen Stroke Risk Score; ABCD²; RRE-90
Schlagwörter: Ischämischer Schlaganfall; Frühe Reischämie; Essen Stroke Risk Score; ABCD²; RRE-90
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