Model provides clinicians with a practical bedside tool for stratifying in-hospital mortality risk
MONDAY, Sept. 27 (HealthDay News) -- Using Get With The Guidelines-Stroke (GWTG-Stroke) data, researchers have developed a new mortality risk predictor for patients hospitalized with ischemic stroke, according to research published online Sept. 27 in Circulation.
Eric E. Smith, M.D., of the University of Calgary in Canada, and colleagues analyzed GWTG-Stroke data for 274,988 ischemic stroke patients to identify predictors of in-hospital mortality. The predictors were assigned point scores to develop a mortality prediction model, which was then validated in a subgroup of patients. The researchers also separately developed and validated models based on 109,187 patients for whom National Institutes of Health Stroke Scale (NIHSS) scores were recorded.
In-hospital mortality was 5.5 percent overall and 5.2 percent for patients with NIHSS scores. The researchers found that in-hospital mortality was associated with age, arrival mode (ambulance versus other mode), history of atrial fibrillation, prior stroke, prior myocardial infarction, carotid stenosis, diabetes, peripheral vascular disease, hypertension, history of dyslipidemia, smoking, and weekend or nighttime admission. The C statistic for in-hospital mortality was 0.72 using the overall data and 0.85 in the model including NIHSS scores. A model using just NIHSS scores had a C statistic of 0.83.
"The GWTG-Stroke risk model provides clinicians with a well-validated, practical bedside tool for mortality risk stratification. The NIHSS score provides substantial incremental information on a patient's short-term mortality risk and is the strongest predictor of mortality," the authors write.
The GWTG-Stroke program is supported in part by pharmaceutical company contributions. Also, study authors disclosed financial ties to pharmaceutical and/or medical device companies.
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