Cheng Chun-An, Lin Yi-Ching, Chiu Hung-Wen
Neurology department, Tri-service General Hospital, Taipei, Taiwan.
Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
Stud Health Technol Inform. 2014;202:115-8.
In general, around 80% of all strokes are ischemic. Take caring of the patients who have suffered an ischemic stroke is both expensive and time consuming. It is known that thrombolysis in patients with ischemic stroke can reduce the disability and increase the survival rate, however some patients still have poor outcomes. Therefore, to be able to predict the outcome of ischemic stroke patients after intravenous thrombolysis would be useful while making clinical decisions. In this study, we collected retrospective data of 82 ischemic stroke patients who received intravenous thrombolysis from July 2005 to June 2012 in Tri-service General Hospital. Of these patients, 10 died within 3 months, and only 36 patients made a good recovery. We used STATISTICA 10 software to select the best artificial neural network. The parameters of model 1 were age, blood sugar, onset to treatment time, National Institute of Health Stroke Scale (NIHSS) score, dense cerebral artery sign, and old stroke to predict 3-month outcomes. The parameters of model 2 were age, onset to treatment time, NIHSS score, hypertension, heart disease, diabetes and old stroke to predict the 3-month prognosis. The sensitivity, specificity and accuracy for model 1 were 77.78%, 80.43% and 79.27%, respectively, and 94.44%, 95.65% and 95.12%, respectively, for model 2. Artificial neural networks are used to establish prediction models with good performance to predict thrombolysis outcomes. These models may be able to help physicians to discuss and explain the likely outcomes to patients and their families before thrombolysis treatment.
一般来说,所有中风病例中约80%为缺血性中风。照顾缺血性中风患者既昂贵又耗时。众所周知,对缺血性中风患者进行溶栓治疗可减少残疾并提高生存率,然而仍有一些患者预后不佳。因此,能够预测缺血性中风患者静脉溶栓后的预后情况,将有助于临床决策。在本研究中,我们收集了2005年7月至2012年6月在三军总医院接受静脉溶栓治疗的82例缺血性中风患者的回顾性数据。在这些患者中,10例在3个月内死亡,只有36例患者恢复良好。我们使用STATISTICA 10软件选择最佳人工神经网络。模型1的参数包括年龄、血糖、发病至治疗时间、美国国立卫生研究院卒中量表(NIHSS)评分、大脑中动脉高密度征和既往中风史,用于预测3个月后的预后情况。模型2的参数包括年龄、发病至治疗时间、NIHSS评分、高血压、心脏病、糖尿病和既往中风史,用于预测3个月后的预后情况。模型1的敏感性、特异性和准确性分别为77.78%、80.43%和79.27%,模型2的分别为94.44%、95.65%和95.12%。人工神经网络用于建立性能良好的预测模型,以预测溶栓治疗结果。这些模型或许能够帮助医生在溶栓治疗前向患者及其家属讨论并解释可能的治疗结果。