Fuck, I don't want prognostication you blithering idiots, I want solutions that will prevent early mortality. Are you that fucking clueless about stroke survivor needs?
Originally published14 Dec 2018Stroke. 2018;0:STROKEAHA.118.022863
Abstract
Background and Purpose—
Several
risk factors are known to increase mid- and long-term mortality of
ischemic stroke patients. Information on predictors of early stroke
mortality is scarce but often requested in clinical practice. We
therefore aimed to develop a rapidly applicable tool for predicting
early mortality at the stroke unit.
Methods—
We
used data from the nationwide Austrian Stroke Unit Registry and
multivariate regularized logistic regression analysis to identify
demographic and clinical variables associated with early (≤7 days
poststroke) mortality of patients admitted with ischemic stroke. These
variables were then used to develop the Predicting Early Mortality of
Ischemic Stroke score that was validated both by bootstrapping and
temporal validation.
Results—
In
total, 77 653 ischemic stroke patients were included in the analysis
(median age: 74 years, 47% women). The mortality rate at the stroke unit
was 2% and median stay of deceased patients was 3 days. Age, stroke
severity measured by the National Institutes of Health Stroke Scale,
prestroke functional disability (modified Rankin Scale >0),
preexisting heart disease, diabetes mellitus, posterior circulation
stroke syndrome, and nonlacunar stroke cause were associated with
mortality and served to build the Predicting Early Mortality of Ischemic
Stroke score ranging from 0 to 12 points. The area under the curve of
the score was 0.879 (95% CI, 0.871–0.886) in the derivation cohort and
0.884 (95% CI, 0.863–0.905) in the validation sample. Patients with a
score ≥10 had a 35% (95% CI, 28%–43%) risk to die within the first days
at the stroke unit.
Conclusions—
We
developed a simple score to estimate early mortality of ischemic stroke
patients treated at a stroke unit. This score could help clinicians in
short-term prognostication for management decisions and counseling.
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