Preliminary Research For Application And Improvement Of Essen Stroke Risk Score

Objective: To evaluate the ability of Essen Stroke Risk Score (ESRS) and explore the ability of the Union Score which consists of ESRS,low density lipoprotein (LDL) and angiography of intracranial or extracranial arteries in predicting recurrence ischemic stroke risk for Chinese, and select which one has the more predictive accuracy.Methods: There are eighty patients (exclude the patients with AF) hospitalized with acute cerebral infarction or transient ischemic attack from March to December in 2010, and the onset is within one month. Inquire illness history and complete LDL test,carotid vessels ultrasound and MRA/CTA/DSA of the head. The first test of LDL>3.37mmol/L after hospitalization is high. The extracranial arteries consist of common carotid artery,extracranial-internal carotid artery and extracranial-vertebral artery. We consider the one with most serious stenosis as the standard. The intracranial arteries consist of middle cerebral artery,anterior cerebral artery,posterior cerebral artery,intracranial-internal carotid artery (up fromC3),intracranial-vertebral artery and basilar artery. We also consider the one with most serious stenosis as the standard. Based on the ESRS, we establish a new prediction model- the Union Score. It includes three new aspects. 1. LDL>3.37mmol/L=1; LDL≤3.37mmol/L=0. 2. Extracranial artery: no stenosis=0; mild stenosis=1; moderate stenosis=2; serious stenosis=3. 3. Intracranial artery: no stenosis=0; mild stenosis=1; moderate stenosis=2; serious stenosis=3.The eighty patients were evaluated according to ESRS and the Union Score. The occurrences of recurrence ischemic stroke were observed in three months. Deal with the data using the SPSS 11.5 statistics software, the counting material is expressed with frequency (percentage) or X_±s. We evaluate the two prediction models with the ROC Curve and analyse the risk factors with Logistic Regression, P<0.05 has statistics significance. Results:1.The AUCs (95%CI) of ESRS:A1=0.691(0.518~0.864),P=0.030.The ESRS has predictive accuracy in predicting recurrence ischemic stroke risk for Chinese.2.The AUCs (95%CI) of the Union Score:A2=0.893(0.808~0.977), P=0.000. A2>A1,P<0.05, the predictive accuracy of the Union Score is higher than that of ESRS.Conclusions:1.The ESRS has predictive accuracy for the onset of acute cerebral infarction or transient ischemic attack.2.The predictive accuracy of the Union Score is higher than that of ESRS. It deserves further evaluating clinically.3.It will be needed to further expand the sample size and analysis whether to control the risk factors and the degree of the control to evaluate the ability of the Union Score accurately.