From the Department of Neuroscience, Kaiser Permanente, Redwood City, CA (A.C.F., B.S.F., S.P.C., V.A.R.); Department of Neurology and Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY (H.K.); Departments of Neurology, Neurosurgery, and Radiology, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA (R.G.); Department of Neurology, University of California San Francisco (W.S.S.); Stroke Trials Unit, University of Nottingham, Nottingham, United Kingdom (P.M.B.); and The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (G.A.D.).
Stroke. 2013 Dec;44(12):3365-9. doi: 10.1161/STROKEAHA.113.002794. Epub 2013 Sep 26.
In previous studies, the Totaled Health Risks in Vascular Events (THRIVE) score has shown broad utility, allowing prediction of clinical outcome, death, and risk of hemorrhage after tissue-type plasminogen activator (tPA) treatment, irrespective of the type of acute stroke therapy applied to the patient.
We used data from the Virtual International Stroke Trials Archive to further validate the THRIVE score in a large cohort of patients receiving tPA or no acute treatment, to confirm the relationship between THRIVE and hemorrhage after tPA, and to compare the THRIVE score with several other available outcome prediction scores.
The THRIVE score strongly predicts clinical outcome (odds ratio, 0.55 for good outcome [95% CI, 0.53-0.57]; P<0.001), mortality (odds ratio, 1.57 [95% confidence interval, 1.50-1.64]; P<0.001), and risk of intracerebral hemorrhage after tPA (odds ratio, 1.34 [95% confidence interval, 1.22-1.46]; P<0.001). The relationship between THRIVE score and outcome is not influenced by the independent relationship of tPA administration and outcome. In receiver operator characteristic curve analysis, the THRIVE score was superior to several other available outcome prediction scores in the prediction of clinical outcome and mortality.
The THRIVE score is a simple-to-use tool to predict clinical outcome, mortality, and risk of hemorrhage after thrombolysis in patients with ischemic stroke. Despite its simplicity, the THRIVE score performs better than several other outcome prediction tools. A free Web calculator for the THRIVE score is available at http://www.thrivescore.org.
在之前的研究中，血管事件总风险（THRIVE）评分具有广泛的适用性，可预测接受组织型纤溶酶原激活剂（tPA）治疗的患者的临床结局、死亡和出血风险，而不论应用何种类型的急性卒中治疗。
我们使用虚拟国际卒中试验档案的数据，进一步验证了THRIVE 评分在接受 tPA 或无急性治疗的大样本患者中的有效性，以确认 THRIVE 与 tPA 后出血之间的关系，并比较 THRIVE 评分与其他几种可用的预后预测评分。
THRIVE 评分强烈预测临床结局（优势比，良好结局为 0.55 [95%置信区间，0.53-0.57]；P<0.001）、死亡率（优势比，1.57 [95%置信区间，1.50-1.64]；P<0.001）和 tPA 后颅内出血风险（优势比，1.34 [95%置信区间，1.22-1.46]；P<0.001）。THRIVE 评分与结局之间的关系不受 tPA 给药与结局之间的独立关系的影响。在接受者操作特征曲线分析中，THRIVE 评分在预测临床结局和死亡率方面优于其他几种可用的预后预测评分。
THRIVE 评分是一种简单易用的工具，可预测缺血性卒中患者溶栓后临床结局、死亡率和出血风险。尽管简单，但 THRIVE 评分的性能优于其他几种预后预测工具。THRIVE 评分的免费网络计算器可在 http://www.thrivescore.org 获得。
