{"title":"关于溶栓患者预后预测价值的 Barthel 指数、SPAN-100 和 NIHSS 研究。","authors":"Meng Fu, Yani Fan, Shuangmei Yan, Sujie Wang, Sai Zhang, Feifei Chen, Rui Han, Xiaohong He, Ping Gu, Jian Li, Lili Chen","doi":"10.1097/NRL.0000000000000554","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We mainly explore the predictive value of Barthel Index (BI), SPAN-100, and National Institute of Health stroke scale (NIHSS) scores on clinical prognosis and functional outcomes in thrombolytic patients and compare the differences in the predictive values of the above 3 scales so as to provide an effective basis to evaluate the prognosis of thrombolytic patients.</p><p><strong>Methods: </strong>Data were collected from 212 patients with the first-onset AIS (acute ischemic stroke). The enrolled patients were treated with recombinant tissue plasminogen activator thrombolytic therapy and were divided into 2 groups according to the modified Rankin Scale (mRS) score at discharge: the prognosis group (mRS≤2 points) and the poor prognosis group (mRS≥3 points). Logistic multivariate analysis was used to analyze the predictors of poor prognosis in patients with thrombolysis. MedCalc software was used to plot receiver operating characteristic (ROC) curves, calculate the area under the ROC curve (AUC), and compare the prediction performance of the 3 scales by the Delong and colleagues' method, and the difference of P <0.05 was statistically significant.</p><p><strong>Results: </strong>Logistic binary regression multivariate analysis suggested that BI was a predictor of poor prognosis for thrombolytic therapy in patients with AIS. The lower the BI score, the poorer the prognosis. The AUC for BI score was 0.862, 95% CI (0.808-0.906), NIHSS score AUC was 0.665, 95% CI (0.597-0.728), and SPAN-100 score AUC was 0.640, 95% CI (0.572-0.705). AUC comparison of 3 scoring ROC curves suggested statistically significant differences between BI and NIHSS ( PC =0.0000), BI and SPAN-100 ( PC =0.0000); no significant difference was observed between SPAN-100 and NIHSS ( PC =1.7997).</p><p><strong>Conclusions: </strong>Simple BI scores have a high prognostic value for thrombolytic therapy in AIS.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"158-162"},"PeriodicalIF":1.1000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Barthel Index, SPAN-100, and NIHSS Studies on the Predictive Value of Prognosis in Patients With Thrombolysis.\",\"authors\":\"Meng Fu, Yani Fan, Shuangmei Yan, Sujie Wang, Sai Zhang, Feifei Chen, Rui Han, Xiaohong He, Ping Gu, Jian Li, Lili Chen\",\"doi\":\"10.1097/NRL.0000000000000554\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>We mainly explore the predictive value of Barthel Index (BI), SPAN-100, and National Institute of Health stroke scale (NIHSS) scores on clinical prognosis and functional outcomes in thrombolytic patients and compare the differences in the predictive values of the above 3 scales so as to provide an effective basis to evaluate the prognosis of thrombolytic patients.</p><p><strong>Methods: </strong>Data were collected from 212 patients with the first-onset AIS (acute ischemic stroke). The enrolled patients were treated with recombinant tissue plasminogen activator thrombolytic therapy and were divided into 2 groups according to the modified Rankin Scale (mRS) score at discharge: the prognosis group (mRS≤2 points) and the poor prognosis group (mRS≥3 points). Logistic multivariate analysis was used to analyze the predictors of poor prognosis in patients with thrombolysis. MedCalc software was used to plot receiver operating characteristic (ROC) curves, calculate the area under the ROC curve (AUC), and compare the prediction performance of the 3 scales by the Delong and colleagues' method, and the difference of P <0.05 was statistically significant.</p><p><strong>Results: </strong>Logistic binary regression multivariate analysis suggested that BI was a predictor of poor prognosis for thrombolytic therapy in patients with AIS. The lower the BI score, the poorer the prognosis. The AUC for BI score was 0.862, 95% CI (0.808-0.906), NIHSS score AUC was 0.665, 95% CI (0.597-0.728), and SPAN-100 score AUC was 0.640, 95% CI (0.572-0.705). AUC comparison of 3 scoring ROC curves suggested statistically significant differences between BI and NIHSS ( PC =0.0000), BI and SPAN-100 ( PC =0.0000); no significant difference was observed between SPAN-100 and NIHSS ( PC =1.7997).</p><p><strong>Conclusions: </strong>Simple BI scores have a high prognostic value for thrombolytic therapy in AIS.</p>\",\"PeriodicalId\":49758,\"journal\":{\"name\":\"Neurologist\",\"volume\":\" \",\"pages\":\"158-162\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurologist\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/NRL.0000000000000554\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/NRL.0000000000000554","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的主要探讨 Barthel 指数(BI)、SPAN-100 和美国国立卫生研究院卒中量表(NIHSS)评分对溶栓患者临床预后和功能预后的预测价值,比较上述 3 种量表预测价值的差异,为评价溶栓患者的预后提供有效依据:方法:收集212名首次发病的AIS(急性缺血性脑卒中)患者的数据。入组患者均接受重组组织浆细胞酶原激活剂溶栓治疗,并根据出院时的改良Rankin量表(mRS)评分分为两组:预后良好组(mRS≤2分)和预后不良组(mRS≥3分)。采用逻辑多变量分析法分析溶栓患者预后不良的预测因素。使用MedCalc软件绘制接收者操作特征曲线(ROC),计算ROC曲线下面积(AUC),并采用Delong及其同事的方法比较3种量表的预测性能以及PR结果的差异:逻辑二元回归多变量分析表明,BI 是 AIS 患者溶栓治疗预后不良的预测因子。BI 评分越低,预后越差。BI 评分的 AUC 为 0.862,95% CI (0.808-0.906);NIHSS 评分的 AUC 为 0.665,95% CI (0.597-0.728);SPAN-100 评分的 AUC 为 0.640,95% CI (0.572-0.705)。3条评分ROC曲线的AUC比较显示,BI与NIHSS(PC=0.0000)、BI与SPAN-100(PC=0.0000)之间存在显著统计学差异;SPAN-100与NIHSS(PC=1.7997)之间无显著差异:结论:简单的 BI 评分对 AIS 的溶栓治疗具有较高的预后价值。
Barthel Index, SPAN-100, and NIHSS Studies on the Predictive Value of Prognosis in Patients With Thrombolysis.
Objective: We mainly explore the predictive value of Barthel Index (BI), SPAN-100, and National Institute of Health stroke scale (NIHSS) scores on clinical prognosis and functional outcomes in thrombolytic patients and compare the differences in the predictive values of the above 3 scales so as to provide an effective basis to evaluate the prognosis of thrombolytic patients.
Methods: Data were collected from 212 patients with the first-onset AIS (acute ischemic stroke). The enrolled patients were treated with recombinant tissue plasminogen activator thrombolytic therapy and were divided into 2 groups according to the modified Rankin Scale (mRS) score at discharge: the prognosis group (mRS≤2 points) and the poor prognosis group (mRS≥3 points). Logistic multivariate analysis was used to analyze the predictors of poor prognosis in patients with thrombolysis. MedCalc software was used to plot receiver operating characteristic (ROC) curves, calculate the area under the ROC curve (AUC), and compare the prediction performance of the 3 scales by the Delong and colleagues' method, and the difference of P <0.05 was statistically significant.
Results: Logistic binary regression multivariate analysis suggested that BI was a predictor of poor prognosis for thrombolytic therapy in patients with AIS. The lower the BI score, the poorer the prognosis. The AUC for BI score was 0.862, 95% CI (0.808-0.906), NIHSS score AUC was 0.665, 95% CI (0.597-0.728), and SPAN-100 score AUC was 0.640, 95% CI (0.572-0.705). AUC comparison of 3 scoring ROC curves suggested statistically significant differences between BI and NIHSS ( PC =0.0000), BI and SPAN-100 ( PC =0.0000); no significant difference was observed between SPAN-100 and NIHSS ( PC =1.7997).
Conclusions: Simple BI scores have a high prognostic value for thrombolytic therapy in AIS.
期刊介绍:
The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.