Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UK.
Stroke. 2012 Dec;43(12):3378-81. doi: 10.1161/STROKEAHA.112.671073. Epub 2012 Sep 25.
This study aimed to test the explanatory qualities of the Stroke-Thrombolytic Predictive Instrument (S-TPI) when applied to patients treated in routine practice.
S-TPI predictions were compared with observed outcomes in terms of normal/near-normal (modified Rankin Scale score, ≤1) and catastrophic outcome (modified Rankin Scale score, ≥5) at 3 months. Logistic regression was used to calibrate and expand the S-TPI.
The S-TPI overestimated probability of catastrophic outcomes and overestimated the probability of a normal/near normal outcome above 0.4 and underestimated those below. Calibrating the S-TPI minimized discrepancies between predicted and observed outcomes, in the case of normal/near-normal outcomes, where including additional predictors (serum glucose and signs of current infarction on pretreatment brain scan) further reduced discrepancies between predicted and observed outcomes.
The explanatory power of the S-TPI in thrombolytic-treated patients can be improved to reflect outcomes seen in routine practice.
本研究旨在检验卒中溶栓预测工具（S-TPI）在常规实践中应用于治疗患者时的解释能力。
比较 S-TPI 预测与 3 个月时观察到的正常/接近正常（改良 Rankin 量表评分≤1）和灾难性结局（改良 Rankin 量表评分≥5）之间的结果。使用逻辑回归对 S-TPI 进行校准和扩展。
S-TPI 高估了灾难性结局的概率，并高估了 0.4 以上正常/接近正常结局的概率，而低估了低于 0.4 的概率。校准 S-TPI 可以最小化预测结果与观察结果之间的差异，对于正常/接近正常的结果，包括额外的预测因素（血清葡萄糖和治疗前脑扫描上当前梗死的迹象）可以进一步减少预测结果与观察结果之间的差异。
可以提高 S-TPI 在溶栓治疗患者中的解释能力，以反映常规实践中的结果。
