Highlights
- •All patients admitted with acute stroke were included in the cohort
- •Clinical information available at admission was included as predictors
- •The time of follow-up was one year and the main outcome measure was mortality
- •Three prediction models of one-year mortality were constructed
- •Cross-validation was used to validate the models and estimate degree of overfitting
Abstract
Background: In Denmark 15%-20% of stroke victims die within the first year. Simple and valid
tools are needed to assess patients’ risk of dying. The aim of this study was to identify
potential predictors of 1-year mortality in stroke victims and construct a simple
and valid prediction model. Methods: Data were collected retrospectively from a cohort of 1031 stroke victims admitted
over a period of 18 months at Nordsjællands Hospital, Denmark. Follow-up was 1 year
after symptom onset. Multiple logistic regression analysis with backwards selection
was used to identify predictors and construction of a prediction model. The model
was validated using cross validation with 10,000 repeated random splits of the dataset.
Area under the receiver operating characteristic curve (AUC) and Brier score were
used as measures of validity. Results: Within the first year 186 patients died (18.0%) and 4 (0.4%) were lost to follow-up.
Age (OR 1.08), gender (OR 2.19), stroke severity (OR 1.03), Early Warning Score (OR
1.17), Performance Status (ECOG) (OR 1.94), Body Mass Index (OR 0.91), the Charlton's
Comorbidity Index (OR 1.17), and urinary problems (OR 2.55) were found to be independent
predictors of 1-year mortality. A model including age, stroke severity, Early Warning
Score, and Performance Status was found to be valid (AUC 86.5 %, Brier Score 9.03).
Conclusions: A model including only 4 clinical variables available shortly after admission was
able to predict the 1-year mortality risk of patients with acute ischemic and haemorrhagic
stroke.
Key Words
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Article info
Publication history
Published online: February 07, 2020
Accepted:
January 11,
2020
Received in revised form:
January 8,
2020
Received:
October 31,
2019
Footnotes
Funding: No funding was received.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104667
Copyright
© 2020 Elsevier Inc. All rights reserved.
