Department of Internal Medicine, Aging and Nephrological Diseases, Stroke Unit, University of Bologna, Italy.
Acta Neurol Scand. 2011 Nov;124(5):334-42. doi: 10.1111/j.1600-0404.2010.01479.x. Epub 2011 Jan 17.
According to most existing models, a computer is usually needed for predicting stroke outcome. Our purpose was to construct a simple and reliable prognostic scale not requiring the use of a calculating machine.
The scale [the Bologna Outcome Algorithm for Stroke (BOAS)] was obtained in 221 patients with ischemic stroke not undergoing thrombolysis and was then validated in a test group of 100 different patients. Outcome was assessed at 9 months as the number of dependent or dead patients (modified Rankin scale - mRS > 2).
By a preliminary systematic univariate analysis, 25 of 415 baseline variables were found to be associated with a mRS > 2 independently of stroke severity and age. Subsequent multivariable analyses led to a final model based on five dichotomous risk factors (RF): National Institutes of Health Stroke Scale score ≥10, age ≥78, need of urinary catheter, oxygen administration, and persistence of upper limb paralysis at discharge from stroke unit. The patients with two or more RF (53%) had a mRS > 2 in 91% of cases and were dead in 42% of cases. With 0-1 RF, the two percentages were 24% and 2%, respectively (overall accuracy of prediction 83.9%, area under ROC curve [AUC] 0.891). In the test group, the accuracy was 79.0% and the AUC was 0.839.
The need of urinary catheter, oxygen administration, and persistence of upper limb paralysis, together with stroke severity and advanced age, allow a simple and accurate prediction of dependency or death after ischemic stroke.
根据大多数现有模型，预测中风结果通常需要使用计算机。我们的目的是构建一个简单且可靠的预后量表，无需使用计算器。
该量表[博洛尼亚中风结局算法（BOAS）]是在 221 名未接受溶栓治疗的缺血性中风患者中获得的，然后在 100 名不同患者的测试组中进行了验证。通过改良 Rankin 量表（mRS）评估 9 个月时的结局，mRS＞2 为依赖或死亡患者。
通过初步系统的单变量分析，415 个基线变量中有 25 个与 mRS＞2 独立于中风严重程度和年龄相关。随后的多变量分析导致基于 5 个二分类风险因素（RF）的最终模型：国立卫生研究院中风量表（NIHSS）评分≥10、年龄≥78 岁、需要导尿管、氧疗和出院时上肢瘫痪持续存在。有 2 个或更多 RF（53%）的患者中有 91%的 mRS＞2，42%的患者死亡。有 0-1 RF 的患者中，这两个百分比分别为 24%和 2%（总体预测准确率为 83.9%，ROC 曲线下面积[AUC]为 0.891）。在测试组中，准确率为 79.0%，AUC 为 0.839。
导尿管、氧疗和上肢瘫痪的持续存在，加上中风严重程度和高龄，可简单准确地预测缺血性中风后的依赖或死亡。
