Prediction of Outcome in Embolic Strokes of Undetermined Source

Simona Lattanzi, Alessandra Pulcini, Tommaso Corradetti, Claudia Rinaldi, Maria Luisa Zedde, Giuseppe Ciliberti, Mauro Silvestrini

Research output: Contribution to journalArticle

Abstract

Background and Aim: Predicting outcome after stroke is a major goal and research field. The Embolic Stroke of Undetermined Source (ESUS) is a recently introduced clinical construct, and the prediction of outcome in this population has to be further explored. The aim of the study was to evaluate the prognostic validity and accuracy of the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) score in patients with ESUS. Methods: Consecutive patients hospitalized for acute ischemic stroke who met the ESUS diagnostic criteria were identified and the ASTRAL scores estimated. The study endpoint was the 3-month unfavorable outcome (modified Rankin Scale>2). Predictive performance was investigated through logistic regression analysis and discrimination and calibration tests. Results: Among 202 patients with ESUS, 67 (33.2%) had unfavourable 3-month outcome. The ASTRAL score was an independent predictor of poor outcome [adjOR = 1.44, 95% confidence interval (CI) 1.30-1.60, P <. 001], showed good discriminatory power (area under the receiver operating characteristic curve. 913, 95% CI. 871-.956) and was well calibrated (Hosmer-Lemeshow test P =. 496). Conclusions: The ASTRAL score was an independent predictor of 3-month functional outcome and showed high predictive accuracy in patients with ESUS.

Original languageEnglish
Article number104486
JournalJournal of Stroke and Cerebrovascular Diseases
Volume29
Issue number1
DOIs
Publication statusPublished - Jan 2020
Externally publishedYes

Fingerprint

Stroke
Registries
Confidence Intervals
ROC Curve
Calibration
Logistic Models
Regression Analysis
Research
Population

Keywords

  • cerebral ischemia
  • cerebrovascular disease
  • embolic stroke of undetermined source
  • Stroke

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Lattanzi, S., Pulcini, A., Corradetti, T., Rinaldi, C., Zedde, M. L., Ciliberti, G., & Silvestrini, M. (2020). Prediction of Outcome in Embolic Strokes of Undetermined Source. Journal of Stroke and Cerebrovascular Diseases, 29(1), [104486]. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104486

Prediction of Outcome in Embolic Strokes of Undetermined Source. / Lattanzi, Simona; Pulcini, Alessandra; Corradetti, Tommaso; Rinaldi, Claudia; Zedde, Maria Luisa; Ciliberti, Giuseppe; Silvestrini, Mauro.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 29, No. 1, 104486, 01.2020.

Research output: Contribution to journalArticle

Lattanzi, S, Pulcini, A, Corradetti, T, Rinaldi, C, Zedde, ML, Ciliberti, G & Silvestrini, M 2020, 'Prediction of Outcome in Embolic Strokes of Undetermined Source', Journal of Stroke and Cerebrovascular Diseases, vol. 29, no. 1, 104486. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104486
Lattanzi, Simona ; Pulcini, Alessandra ; Corradetti, Tommaso ; Rinaldi, Claudia ; Zedde, Maria Luisa ; Ciliberti, Giuseppe ; Silvestrini, Mauro. / Prediction of Outcome in Embolic Strokes of Undetermined Source. In: Journal of Stroke and Cerebrovascular Diseases. 2020 ; Vol. 29, No. 1.
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