Jiang Yuan, Qiu Shuying, Peng Qianyi, Huang Li, Zhang Lina
Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
Department of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, People's Republic of China.
Sci Rep. 2025 May 15;15(1):16916. doi: 10.1038/s41598-025-00959-7.
Hemorrhagic stroke is a kind of disastrous cerebrovascular disease, Oxford Acute Severity of Illness Score (OASIS) was only evaluated among mixed critically ill patients, its predictive value in hemorrhagic stroke patients remains undiscovered. Evaluate the association between Oxford Acute Severity of Illness Score (OASIS) and mortality in critical hemorrhagic stroke patients. A retrospective cohort study. Data were extracted from a public database named Medical Information Mart for Intensive Care III (MIMIC-III). 1838 critical hemorrhagic stroke patients were included, multivariable logistic regression and receiver operating characteristic (ROC) curves were mainly used to analyze data. ROC curve analyses were also conducted in hemorrhagic stroke patients stratified by Glasgow Coma Scale (GCS) as subgroup analyses. The primary outcome was 30-day mortality. The sample size of this study is 1838 patients. The OASIS was significantly correlated with 30-day mortality (Odds ratio (OR) 1.125 per one-point increase, 95% confidence interval (CI) [1.107-1.144], p < 0.0001), the area under the ROC curve (AUC) of OASIS was comparable to that of Simplified Acute Physiology Score II (SAPSII) for predicting 30-day mortality (AUC: 0.7702 vs. 0.788, P = 0.096). Sensitivity analyses showed the results were stable. In subgroup analyses OASIS also has the similar discriminatory power to predict 30-day mortality for the severe (GCS 3-8) and mild (13-15) hemorrhagic stroke patients, but it has lower discriminatory power to predict 30-day mortality for the moderate (9-12) patients. The OASIS might serve as an alternative choice to predict outcomes of severe and mild hemorrhagic stroke patients in consideration of the practicality. Selection bias was unavoidable because this study was a retrospective observational study.
出血性中风是一种灾难性的脑血管疾病,牛津急性疾病严重程度评分(OASIS)仅在混合重症患者中进行了评估,其在出血性中风患者中的预测价值尚未被发现。评估牛津急性疾病严重程度评分(OASIS)与重症出血性中风患者死亡率之间的关联。一项回顾性队列研究。数据从名为重症监护医学信息数据库III(MIMIC-III)的公共数据库中提取。纳入了1838例重症出血性中风患者,主要采用多变量逻辑回归和受试者工作特征(ROC)曲线分析数据。还对按格拉斯哥昏迷量表(GCS)分层的出血性中风患者进行了ROC曲线分析作为亚组分析。主要结局是30天死亡率。本研究的样本量为1838例患者。OASIS与30天死亡率显著相关(每增加1分,比值比(OR)为1.125,95%置信区间(CI)[1.107-1.144],p<0.0001),OASIS预测30天死亡率的ROC曲线下面积(AUC)与简化急性生理学评分II(SAPSII)相当(AUC:0.7702对0.788,P = 0.096)。敏感性分析表明结果稳定。在亚组分析中,OASIS对重度(GCS 3-8)和轻度(13-15)出血性中风患者预测30天死亡率也具有相似的辨别能力,但对中度(9-12)患者预测30天死亡率的辨别能力较低。考虑到实用性,OASIS可能是预测重度和轻度出血性中风患者预后的一种替代选择。由于本研究是一项回顾性观察性研究,选择偏倚不可避免。