ASTRAL Score Predicts 5-Year Dependence and Mortality in Acute Ischemic Stroke

作者：Papavasileiou Vasileios; Milionis Haralampos; Michel Patrik; Makaritsis Konstantinos; Vemmou Anastasia; Koroboki Eleni; Manios Efstathios; Vemmos Konstantinos; Ntaios George^*

来源：Stroke, 2013, 44(6): 1616-U266.

DOI：10.1161/STROKEAHA.113.001047

• ASTRAL score
• functional outcome
• modified Rankin Scale
• mortality
• stroke prognosis

Background and Purpose-The ASTRAL score was externally validated showing remarkable consistency on 3-month outcome prognosis in patients with acute ischemic stroke. The present study aimed to evaluate ASTRAL score%26apos;s prognostic accuracy to predict 5-year outcome. %26lt;br%26gt;Methods-All consecutive patients with acute ischemic stroke registered in the Athens Stroke Registry between January 1, 1998, and December 31, 2010, were included. Patients were excluded if admitted %26gt;24 hours after symptom onset or if any ASTRAL score component was missing. End points were 5-year unfavorable functional outcome, defined as modified Rankin Scale 3 to 6, and 5-year mortality. For each outcome, the area under the receiver operating characteristics curve was calculated; also, a multivariate Cox proportional hazards analysis was performed to investigate whether the ASTRAL score was an independent predictor of outcome. The Kaplan-Meier product limit method was used to estimate the probability of 5-year survival for each ASTRAL score quartile. %26lt;br%26gt;Results-The area under the receiver operating characteristics curve of the score to predict 5-year unfavorable functional outcome was 0.89, 95% confidence interval 0.88 to 0.91. In multivariate Cox proportional hazards analysis, the ASTRAL score was independently associated with 5-year unfavorable functional outcome (hazard ratio, 1.09; 95% confidence interval, 1.08-1.10). The area under the receiver operating characteristics curve for the ASTRAL score%26apos;s discriminatory power to predict 5-year mortality was 0.81 (95% confidence interval, 0.78-0.83). In multivariate analysis, the ASTRAL score was independently associated with 5-year mortality (hazard ratio, 1.09, 95% confidence interval, 1.08-1.10). During the 5-year follow-up, the probability of survival was significantly lower with increasing ASTRAL score quartiles (log-rank test %26lt;0.001). %26lt;br%26gt;Conclusions-The ASTRAL score reliably predicts 5-year functional outcome and mortality in patients with acute ischemic stroke.

• 出版日期2013-6