Institute for Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians University München, Marchioninistr. 15, 81377, Munich, Germany.
Department of Neurology, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
J Neurol. 2024 Sep;271(9):6238-6246. doi: 10.1007/s00415-024-12552-5. Epub 2024 Jul 31.
Juvenile strokes (< 55 years) account for about 15% of all ischemic strokes. Structured data on clinical outcome in those patients are sparse. Here, we aimed to fill this gap by systematically collecting relevant data and modeling a juvenile stroke prediction score for the 3-month functional outcome.
We retrospectively integrated and analyzed clinical and outcome data of juvenile stroke and TIA patients treated at the LMU University Hospital, LMU Munich, Munich. Good outcome was defined as a modified Rankin Scale of 0-2 or return to baseline of function. We analyzed candidate predictors and developed a predictive model. Predictive abilities were inspected using Area Under the ROC curve (AUROC) and visual representation of the calibration. The model was validated internally.
346 patients were included in the analysis. We observed a good outcome in n = 293 patients (84.7%). The prediction model for an unfavourable outcome had an AUROC of 89.1% (95% CI 83.3-93.1%). The model includes age NIHSS, ASPECTS, blood glucose and type of vessel occlusion as predictors for the individual patient outcome.
Here, we introduce the highly accurate PREDICT-score for the 3-month outcome after juvenile stroke derived from clinical routine data. The PREDICT-score might be helpful in guiding individual patient decisions and designing future studies but needs further prospective validation which is already planned. Trial registration The study has been registered at https://drks.de (DRKS00024407) on March 31, 2022.
青少年卒中（<55 岁）占所有缺血性卒中的 15%左右。关于这些患者的临床结局的结构化数据很少。在这里，我们旨在通过系统地收集相关数据并为 3 个月的功能结局建立青少年卒中预测评分来填补这一空白。
我们回顾性地整合和分析了在慕尼黑 LMU 大学医院治疗的青少年卒中和 TIA 患者的临床和结局数据。良好的结局定义为改良 Rankin 量表评分为 0-2 或功能恢复至基线。我们分析了候选预测因素并开发了预测模型。使用 ROC 曲线下面积（AUROC）和校准的可视化表示来检查预测能力。该模型在内部进行了验证。
346 例患者纳入分析。我们观察到 n=293 例（84.7%）患者的结局良好。不良结局的预测模型的 AUROC 为 89.1%（95%CI 83.3-93.1%）。该模型包括年龄 NIHSS、ASPECTS、血糖和血管闭塞类型作为个体患者结局的预测因素。
在这里，我们从临床常规数据中引入了青少年卒中 3 个月结局的高度准确的 PREDICT 评分。PREDICT 评分可能有助于指导个体患者的决策和设计未来的研究，但需要进一步的前瞻性验证，这已经在计划中。
该研究于 2022 年 3 月 31 日在 https://drks.de（DRKS00024407）注册。
