A predictive score for atrial fibrillation in poststroke patients.

IF 1 4区医学 Q4 NEUROSCIENCES

Arquivos de neuro-psiquiatria Pub Date : 2024-10-01 Epub Date: 2024-08-15 DOI:10.1055/s-0044-1788271

Caroliny Trevisan Teixeira, Vanessa Rizelio, Alexandre Robles, Levi Coelho Maia Barros, Gisele Sampaio Silva, João Brainer Clares de Andrade

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引用次数: 0

Abstract

Background: Atrial fibrillation (AF) is a risk factor for cerebral ischemia. Identifying the presence of AF, especially in paroxysmal cases, may take time and lacks clear support in the literature regarding the optimal investigative approach; in resource-limited settings, identifying a higher-risk group for AF can assist in planning further investigation.

Objective: To develop a scoring tool to predict the risk of incident AF in the poststroke follow-up.

Methods: A retrospective longitudinal study with data collected from electronic medical records of patients hospitalized and followed up for cerebral ischemia from 2014 to 2021 at a tertiary stroke center. Demographic, clinical, laboratory, electrocardiogram, and echocardiogram data, as well as neuroimaging data, were collected. Stepwise logistic regression was employed to identify associated variables. A score with integer numbers was created based on beta coefficients. Calibration and validation were performed to evaluate accuracy.

Results: We included 872 patients in the final analysis. The score was created with left atrial diameter ≥ 42 mm (2 points), age ≥ 70 years (1 point), presence of septal aneurysm (2 points), and score ≥ 6 points at admission on the National Institutes of Health Stroke Scale (NIHSS; 1 point). The score ranges from 0 to 6. Patients with a score ≥ 2 points had a fivefold increased risk of having AF detected in the follow-up. The area under the curve (AUC) was of 0.77 (0.72-0.85).

Conclusion: We were able structure an accurate risk score tool for incident AF, which could be validated in multicenter samples in future studies.

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脑卒中后患者心房颤动的预测评分。

背景：心房颤动（房颤）是脑缺血的一个危险因素。在资源有限的情况下，确定心房颤动的高危人群有助于制定进一步的调查计划：方法：一项回顾性纵向研究：方法：一项回顾性纵向研究，数据来自一家三级卒中中心 2014 年至 2021 年期间因脑缺血住院并接受随访的患者的电子病历。研究收集了人口统计学、临床、实验室、心电图、超声心动图数据以及神经影像学数据。采用逐步逻辑回归法确定相关变量。根据贝塔系数创建了一个整数分数。为了评估准确性，我们进行了校准和验证：我们在最终分析中纳入了 872 名患者。评分标准为：左心房直径≥42 毫米（2 分），年龄≥70 岁（1 分），存在房间隔动脉瘤（2 分），入院时美国国立卫生研究院卒中量表（NIHSS；1 分）评分≥6 分。评分范围为 0 至 6 分。评分≥2分的患者在随访中发现房颤的风险增加了5倍。曲线下面积（AUC）为 0.77（0.72-0.85）：我们能够构建一个准确的心房颤动事件风险评分工具，并在未来的研究中在多中心样本中进行验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arquivos de neuro-psiquiatria 医学-精神病学

CiteScore

2.10

自引率

7.10%

发文量

262

审稿时长

4-8 weeks

期刊介绍： Arquivos de Neuro-Psiquiatria is the official journal of the Brazilian Academy of Neurology. The mission of the journal is to provide neurologists, specialists and researchers in Neurology and related fields with open access to original articles (clinical and translational research), editorials, reviews, historical papers, neuroimages and letters about published manuscripts. It also publishes the consensus and guidelines on Neurology, as well as educational and scientific material from the different scientific departments of the Brazilian Academy of Neurology. The ultimate goals of the journal are to contribute to advance knowledge in the areas of Neurology and Neuroscience, and to provide valuable material for training and continuing education for neurologists and other health professionals working in the area. These goals might contribute to improving care for patients with neurological diseases. We aim to be the best Neuroscience journal in Latin America within the peer review system.