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Prediction tool identified disability, death risk after stroke
Researchers developed a clinical prediction rule, called the PLAN score, which was found to aid in the identification of patients at risk for poor outcomes after hospitalization for acute ischemic stroke.
According to data published in Archives of Internal Medicine, use of the PLAN score successfully predicted mortality at 30 days and 1 year, death severe dependence at discharge and favorable outcome at discharge.
To validate the rule, researchers analyzed data on 9,847 patients from the Registry of the Canadian Stroke Network who were hospitalized with acute ischemic stroke at one of 11 regional stroke centers in Ontario, Canada. About half (n=4,943) were classified as the derivation cohort and half (n=4,904) as the validation cohort. The mean age of the patients was 73 years.
Overall mortality at 30 days was 11.5% in the derivation cohort and 13.5% in the validation cohort.
“We reported a new clinical prediction rule (PLAN) with a simple scoring system that can be used by general clinicians at the time of admission of patients with acute ischemic stroke and appears to have adequate discrimination for use in clinical practice. Although the PLAN rule requires external validation in other populations, it represents a promising tool for use in hospital-based medicine,” Martin J. O’Donnell, MB, PhD, and investigators for the Registry of the Canadian Stroke Network wrote.
The bedside prediction score is derived from pre-admission comorbidities, level of consciousness, age and neurologic deficit. The researchers developed the clinical prediction rule for use by general clinicians at the time of hospital admission for death and severe disability after acute ischemic stroke. The researchers included nine clinical variables categorized as pre-admission comorbidities in the final multivariate model: pre-admission dependence; cancer; congestive HF; AF; level of consciousness, age, neurologic deficit, weakness of the arm, and aphasia or neglect.
Additional studies are required to independently validate the PLAN rule in different populations and settings, the researchers said.
Disclosure: The researchers report no relevant financial disclosures.