mSOAR评分对急性缺血性卒中患者不良预后风险预测价值的探讨  

Validation of mSORE score for predicting poor outcome in acute ischemic stroke

作　　者：计海峰[1] 杨雪莲[1] 姚峪岚 蔡丽瑛[1] 来小音[1] 吴大玉 徐瑜梅 江梅[1] JI Haifeng;YANG Xuelian;YAO Yulan;CAI Liying;LAI Xiaoyin;WU Dayu;XU Yumei;JIANG Mei(Department of Neurology;Department of Critical Care Medicine,Shanghai Gongli Hospital,Shanghai 200135,China)

机构地区：[1]上海市浦东新区公利医院神经内科,上海200135 [2]上海市浦东新区公利医院重症医学科,上海200135

出　　处：《诊断学理论与实践》2018年第4期423-427,共5页Journal of Diagnostics Concepts & Practice

基　　金：上海市浦东新区卫生系统学科带头人培养计划(PWRd2014-09);浦东新区科技发展基金(PKJ2017-Y24);国家自然科学基金(81201029;81771328);上海市医学重点专科建设计划项目(ZK2015B16);上海市卫生计生系统优秀学科带头人培养计划(2017BR051)

摘　　要：目的:探讨改良SOAR(Stroke subtype,Oxfordshire community stroke project classification,Age and prestroke modified rankin,m SOAR)评分对我国急性缺血性卒中(acute ischemic stroke,AIS)患者出院时发生不良预后事件的预测价值。方法:分析2014年10月至2017年12月公利医院神经内科和急诊科收治的AIS患者1 461例,记录年龄、性别、牛津郡社区卒中项目(Oxfordshire community stroke project,OCSP)分型、卒中前改良Rankin量表(modified Rankin Scale,m RS)评分和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分等信息,并于入院时使用m SOAR量表进行评分。所有患者出院时均行m RS评分,以出院时出现死亡或重度残疾(m RS≥4分)作为不良预后事件。结果:出院时382例(26.1%)患者出现不良预后事件。在m SOAR评分1~6分之间,每增加1分,患者出院时存在残疾的风险都会有显著增加(P<0.001),出院时不良预后风险在m SOAR评分0~3分组与4~8分组之间差异有统计学意义(P<0.001)。m SOAR评分预测患者出院时不良预后风险时的受试者工作特征(receiver operating characteristic curve,ROC)曲线下面积(area under curve,AUC)为0.868(95%CI为0.844~0.891)。结论:m SOAR量表对我国AIS患者出院时发生不良预后事件的风险预测能力较强。Objective： To explore the value of m SOAR score for predicting the occurrence of adverse prognostic events at discharge in patients with acute ischemic stroke（AIS）. Methods： From October 2014 to December 2017, a total of 1 461 AIS patients hospitalized in Neurology Department and Emergency Department of our hospital were enrolled.Related baseline data including age, gender were recorded and Oxfordshire Community Stroke Project（OCSP） classification, pre-stroke modified Rankin scale（m RS） score, and National Institute of Health Stroke Scale（NIHSS） score as well as the m SOAR score were assessed at admission. The adverse prognostic events were defined as death or poor functional outcome with modified Rankin Scale（≥4） when patients were discharged. Results： Of all the subjects, 382 cases（26.1%）had adverse prognostic events at discharge. Between points 1-6, a one-point increase in m SOAR score resulted in a significant increase in risk of poor prognosis at discharge（P〈 0.001）, and the risk of poor prognosis at discharge between 0-3 and 4-8 in m SOAR score was significantly different（P〈 0.001）. The risk of poor prognosis at discharge was predicted and the AUC value for the m SOAR score was 0.868（95% CI 0.844-0.891）. Conclusions： m SOAR score has a strong ability for predicting the risk of adverse prognostic events at discharge in patients with acute ischemic stroke.

关 键 词：缺血性卒中 预后 量表 受试者工作特征曲线 

分 类 号：R743[医药卫生—神经病学与精神病学]