用于预测短暂症状伴梗死发作后卒中风险的RRE - 90量表的验证：一项前瞻性队列研究
Validation of the RRE-90 Scale to Predict Stroke Risk after Transient Symptoms with Infarction: A Prospective Cohort Study.
作者信息
Song Bo, Pei Lulu, Fang Hui, Zhao Lu, Gao Yuan, Wang Yuanyuan, Tan Song, Xu Yuming
机构信息
Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
Department of Neurology, the Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China.
出版信息
PLoS One. 2015 Sep 22;10(9):e0137425. doi: 10.1371/journal.pone.0137425. eCollection 2015.
BACKGROUND AND PURPOSE
The risk of stroke after a transient ischemic attack (TIA) for patients with a positive diffusion-weighted image (DWI), i.e., transient symptoms with infarction (TSI), is much higher than for those with a negative DWI. The aim of this study was to validate the predictive value of a web-based recurrence risk estimator (RRE; http://www.nmr.mgh.harvard.edu/RRE/) of TSI.
METHODS
Data from the prospective hospital-based TIA database of the First Affiliated Hospital of Zhengzhou University were analyzed. The RRE and ABCD2 scores were calculated within 7 days of symptom onset. The predictive outcome was ischemic stroke occurrence at 90 days. The receiver-operating characteristics curves were plotted, and the predictive value of the two models was assessed by computing the C statistics.
RESULTS
A total of 221 eligible patients were prospectively enrolled, of whom 46 (20.81%) experienced a stroke within 90 days. The 90-day stroke risk in high-risk TSI patients (RRE ≥4) was 3.406-fold greater than in those at low risk (P <0.001). The C statistic of RRE (0.681; 95% confidence interval [CI], 0.592-0.771) was statistically higher than that of ABCD2 score (0.546; 95% CI, 0.454-0.638; Z = 2.115; P = 0.0344) at 90 days.
CONCLUSION
The RRE score had a higher predictive value than the ABCD2 score for assessing the 90-day risk of stroke after TSI.
背景与目的
对于弥散加权成像（DWI）呈阳性的短暂性脑缺血发作（TIA）患者，即伴有梗死的短暂性症状（TSI）患者，其发生卒中的风险远高于DWI呈阴性的患者。本研究旨在验证基于网络的TSI复发风险评估器（RRE；http://www.nmr.mgh.harvard.edu/RRE/）的预测价值。
方法
对来自郑州大学第一附属医院前瞻性医院TIA数据库的数据进行分析。在症状发作7天内计算RRE和ABCD2评分。预测结果为90天时缺血性卒中的发生情况。绘制受试者工作特征曲线，并通过计算C统计量评估两种模型的预测价值。
结果
共前瞻性纳入221例符合条件的患者，其中46例（20.81%）在90天内发生了卒中。高危TSI患者（RRE≥4）90天卒中风险比低危患者高3.406倍（P<0.001）。90天时，RRE的C统计量（0.681；95%置信区间[CI]，0.592 - 0.771）在统计学上高于ABCD2评分的C统计量（0.546；95%CI，0.454 - 0.638；Z = 2.115；P = 0.0344）。
结论
在评估TSI后90天卒中风险方面，RRE评分比ABCD2评分具有更高的预测价值。
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