Rempe David A
Continuum (Minneap Minn). 2014 Apr;20(2 Cerebrovascular Disease):412-28. doi: 10.1212/01.CON.0000446110.97667.58.
Predicting functional outcome and mortality after stroke, with or without thrombolysis, is a critical role of neurologists. This article reviews the predictors of outcome after ischemic stroke.
Several scores were recently designed to predict (1) mortality and poor functional outcome after ischemic stroke, (2) the functional outcome and risk of symptomatic intracranial hemorrhage (sICH) after thrombolysis, and (3) the risk of stroke following TIA. Validation of these prediction instruments is ongoing, and studies will be critical to determine the general applicability of these scores.
Although several scores were developed to predict mortality and outcome after stroke, it may be premature to employ these prediction scores to determine individual patient outcome. Similarly, prediction scores should not be used to deny patients tissue plasminogen activator (tPA), even if the scores predict that the patient has a high likelihood of sICH or poor outcome after thrombolysis.
预测中风（无论是否进行溶栓治疗）后的功能转归和死亡率是神经科医生的一项关键职责。本文综述了缺血性中风后转归的预测因素。
最近设计了几个评分系统来预测（1）缺血性中风后的死亡率和不良功能转归，（2）溶栓治疗后的功能转归和症状性颅内出血（sICH）风险，以及（3）短暂性脑缺血发作（TIA）后中风的风险。这些预测工具的验证工作正在进行，研究对于确定这些评分系统的普遍适用性至关重要。
尽管已经开发了几个评分系统来预测中风后的死亡率和转归，但使用这些预测评分来确定个体患者的转归可能为时过早。同样，即使评分预测患者溶栓后发生sICH或转归不良的可能性很高，也不应使用预测评分来拒绝患者使用组织纤溶酶原激活剂（tPA）。
