Fan Yani, Shi Guoyan, Wang Sujie, Lu Yadan, Kong Xianghui, Chen Lili
Tangshan Gongren Hospital, Tangshan City, Hebei Province, China.
J Thromb Thrombolysis. 2025 Jan;58(1):120-125. doi: 10.1007/s11239-024-03039-1. Epub 2024 Sep 6.
This study aimed to validate the predictive performance of ASTRAL and THRIVE scales when used for patients aged 60 years and older with acute ischemic stroke (AIS) after intravenous thrombolysis (IVT). All enrolled patients received IVT therapy. The enrolled patients were divided into two groups in accordance with the modified Rankin scale(mRS) score at the time of discharge: good-outcome (mRS ≤ 2) and poor-outcome (mRS ≥ 3) groups. The receiver operating characteristic (ROC) curve was plotted using MedCalc software, the area under the ROC curve (AUC) was calculated. The Delong test was used to compare the predictive performance of ASTRAL and THRIVE scales, with P < 0.05 being considered a statistically significant difference. The AUCs of ASTRAL and THRIVE in predicting poor outcomes after thrombolysis in elderly patients with AIS were 0.771 and 0.701, respectively. The difference in AUC between ASTRAL and THRIVE was 0.070, and a statistically significant difference (P < 0.05) was found. ASTRAL's predictive performance was better than that of THRIVE. ASTRAL is a reliable predictive tool for assessing the poor outcome of IVT therapy for elderly patients aged ≥ 60 years with AIS.
本研究旨在验证ASTRAL和THRIVE量表用于60岁及以上急性缺血性卒中（AIS）患者静脉溶栓（IVT）后的预测性能。所有纳入的患者均接受IVT治疗。纳入的患者根据出院时的改良Rankin量表（mRS）评分分为两组：良好预后（mRS≤2）组和不良预后（mRS≥3）组。使用MedCalc软件绘制受试者工作特征（ROC）曲线，计算ROC曲线下面积（AUC）。采用Delong检验比较ASTRAL和THRIVE量表的预测性能，P<0.05被认为具有统计学显著差异。ASTRAL和THRIVE预测老年AIS患者溶栓后不良结局的AUC分别为0.771和0.701。ASTRAL和THRIVE之间的AUC差异为0.070，差异具有统计学意义（P<0.05）。ASTRAL的预测性能优于THRIVE。ASTRAL是评估60岁及以上老年AIS患者IVT治疗不良结局的可靠预测工具。
