Zhao Yuanqi, Zhao Min, Li Xiaomin, Ma Xiancong, Zheng Qinghao, Chen Xiaosheng, Lin Yinwing, Cai Yefeng
Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, China.
PLoS One. 2014 Dec 22;9(12):e113967. doi: 10.1371/journal.pone.0113967. eCollection 2014.
Evaluate the predictive value of Boston Acute Stroke Imaging Scale (BASIS) in acute ischemic stroke in Chinese population.
This was a retrospective study. 566 patients of acute ischemic stroke were classified as having a major stroke or minor stroke based on BASIS. We compared short-term outcome (death, occurrence of complications, admission to intensive care unit [ICU] or neurological intensive care unit [NICU]), long-term outcome (death, recurrence of stroke, myocardial infarction, modified Rankin scale) and economic index including in-hospital cost and length of hospitalization. Continuous variables were compared by using the Student t test or Kruskal-Wallis test. Categorical variables were tested with the Chi square test. Cox regression analysis was applied to identify whether BASIS was the independent predictive variable of death.
During hospitalization, 9 patients (4.6%) died in major stroke group while no patients died in minor stroke group (p < 0.001), 12 patients in the major stroke group and 5 patients in minor stroke group were admitted to ICU/NICU (p = 0.001). There were more complications (cerebral hernia, pneumonia, urinary tract infection) in major stroke group than minor stroke group (p<0.05). Meanwhile, the average cost of hospitalization in major stroke group was 3,100 US$ and 1,740 US$ in minor stroke group (p<0.001); the average length of stay in major and minor stroke group was 21.3 days and 17.3 days respectively (p<0.001). Results of the follow-up showed that 52 patients (26.7%) died in major stroke group while 56 patients (15.1%) died in minor stroke group (P<0.001). 62.2% of the patients in major stroke group and 80.4% of the patients in minor stroke group were able to live independently (P = 0.002). The survival analysis showed that patients with major stroke had 80% higher of risk of death than patients with minor stroke even after adjusting traditional atherosclerotic factors and NIHSS at baseline (HR = 1.8, 95% CI: 1.1-3.1).
BASIS can predict in-hospital mortality, occurrence of complication, length of stay and hospitalization cost of the acute ischemic stroke patients and can also estimate the long term outcome (death and the dependency). BASIS could and should be used as a dichotomous stroke classification system in the daily practice.
评估波士顿急性卒中影像量表（BASIS）对中国急性缺血性卒中人群的预测价值。
这是一项回顾性研究。566例急性缺血性卒中患者根据BASIS被分为重度卒中或轻度卒中。我们比较了短期结局（死亡、并发症发生、入住重症监护病房[ICU]或神经重症监护病房[NICU]）、长期结局（死亡、卒中复发、心肌梗死、改良Rankin量表）以及包括住院费用和住院时间在内的经济指标。连续变量采用Student t检验或Kruskal-Wallis检验进行比较。分类变量采用卡方检验。应用Cox回归分析确定BASIS是否为死亡的独立预测变量。
住院期间，重度卒中组9例患者（4.6%）死亡，而轻度卒中组无患者死亡（p<0.001），重度卒中组12例患者和轻度卒中组5例患者入住ICU/NICU（p = 0.001）。重度卒中组的并发症（脑疝、肺炎、尿路感染）比轻度卒中组更多（p<0.05）。同时，重度卒中组的平均住院费用为3100美元，轻度卒中组为1740美元（p<0.001）；重度和轻度卒中组的平均住院时间分别为21.3天和17.3天（p<0.001）。随访结果显示，重度卒中组52例患者（26.7%）死亡，而轻度卒中组56例患者（15.1%）死亡（P<0.001）。重度卒中组62.2%的患者和轻度卒中组80.4%的患者能够独立生活（P = 0.002）。生存分析表明，即使在调整了传统动脉粥样硬化因素和基线NIHSS后，重度卒中患者的死亡风险仍比轻度卒中患者高80%（HR = 1.8，95%CI：1.1 - 3.1）。
BASIS可以预测急性缺血性卒中患者的住院死亡率、并发症发生情况、住院时间和住院费用，还可以评估长期结局（死亡和依赖情况）。在日常实践中，BASIS可以且应该用作二分法卒中分类系统。
