The Prognostic Value Of The THRIVE Score,the IScore Score And The ASTRAL Score For 1-year With Acute Ischemic Stroke

Background Acute ischemic stroke(AIS) has a higher morbidity and mortality rate.Many prediction tools have been developed to predict the risk of poor outcomes in patients after AIS,such as the THRIVE score,the iScore score,and the ASTRAL score.However,the predictive value of above 3 prediction tools in Chinese patients with AIS need to be further verified.Objective To explore the predictive value of THRIVE Score,the iScore Score and the ASTRAL Score for poor prognosis and outcome of AIS patients at 1 year.Methods A total of 772 patients with AIS were included in this study from the Department of Neurology between December 2012 and September 2016.The baseline data of all patients were collected.The THRIVE score,the iScore score,and the ASTRAL score were calculated.All patients were followed up at 1 year.Patients with death or functional disability(modified Rankin Scale(m RS)>2)at 1 year were regarded as poor outcome events,and severe disability outcome was regarded as m RS≥5 at 1 year.Area under the curve(AUC) of receiver operating characteristic(ROC) was used to compare the predictive value of the three scores.Hosmer-lemeshow test was used to evaluate the goodness of fit of each model.Pearson correlation analysis was used to assess the degree of correlation between actual and expected outcome events.Results We included 772 patients in this study,including 576 patients(74.6%) with good prognosis and 196 patients(25.4%) with poor outcomes in which 68 patients(34.7%) was died.The AUC values predicted by THRIVE score,iScore score and ASTRAL score for poor prognosis of AIS patients at 1 year were 0.777[95%CI,(0.738,0.815)],0.831[95%CI,(0.796,0.865)] and 0.860[95%CI,(0.830,0.890)],respectively(all P <0.001).For the pairwise comparison,the AUC value of the THRIVE score was lower than the iScore and ASTRAL scores,and the difference was statistically significant(P<0.05).The chi-square values of Hosmer-Lemeshow tes for the 3 prediction scores were 2.114,4.877,5.838(all P>0.05),respectively.Pearson correlation analysis was applied,and the correlation coefficients were 0.985,0.693,and 0.620,respectively(all P<0.05).Further analysis of the 1-year mortality outcomes,AUC values were 0.775 [95% CI,(0.721,0.828)],0.830 [95% CI,(0.781,0.879)],0.809 [95% CI,(0.758,0.860)](all P<0.001).For the pairwise comparison,the AUC of the THRIVE score was lower than the iScore score,the difference was statistically significant(P<0.05).For the analysis of the 1-year severe disability outcomes,the AUC values for the three scores were 0.813 [95% CI,(0.769,0.857)],0.856 [95%CI,(0.816,0.897)],0.843 [95%CI,(0.801,0.884)].For the pairwise comparison,the AUC value of the THRIVE score was lower than the iScore score,and the difference was statistically significant(P< 0.05).Conclusions THRIVE,iScore and ASTRAL scores can all predict the 1-year poor prognosis of AIS population.But the iScore score and ASTRAL score have better predictive efficacy in 1-year poor outcomes in patients with AIS.And the iScore score can accurately predict 1-year mortality and severe disability in patients with AIS.