Role of Alberta Stroke Programme Early Computed Tomography Score (PC- ASPECT) in Predicting Functional Outcome of Patients with Posterior Circulation Stroke - A Prospective Observational Study
Notice bibliographique
Résumé
Objective: 1) To investigate the unfavourable outcome predictors of posterior circulation stroke. 2) To compare the PC-ASPECTS with respect to functional outcome prediction using Modified Rankin Scale and NIHSS (National institute of health stroke scale) 3) To identify the optimal cut-off point for the PC-ASPECTS for predicting favourable and unfavourable functional outcomes. Sample Size: Favourable functional outcome prediction in posterior circulation acute ischemic stroke has been observed in 64% from the previous study. Considering the 95% level of confidence interval (Z=1.96) with 10% precision (d=0.1) the minimum requiredsample size is - = ( ) ( -) () = (.) (.) ( -.) (.) = . Therefore, the minimum required sample for the study is 89.Article considered for the sample size calculation: "Predicting functional outcomes of posterior circulation acute ischemic stroke in first 36 h of stroke onset" by Sheng-Feng Lin.Statistical Analysis Plan: All the qualitative parameters like sex, complaints, risk factors, etc, represented with frequencies and percentages.Quantitative parameters like Age, NIHSS score, PC Aspect score, etc., represented with Mean with standard deviation.To find the association between qualitative factors we used Chi-Square test for measure of association.To find the relation between NIHSS, MRS, PC Aspects scores we used Pearson's correlation.To compare mean difference we used unpaired t-test.P value less than 0.05 considered as significance.Data entered in Ms. Excel and Analyzed by using SPSS 19.0v.Conclusions and Results: 1) It was observed that 50 (55.6%)patients were in the age group of 60 years and above followed by 35 (38.9%) in the age group of 46-60 years.2) Males were affected more i.e. 72 (80%) compared to the female patients 18 (20%).3) Most observed co-morbid condition was diabetes in 56(62.2%)patients followed by hypertension in 55(61.1%)patients and smoking in 44(48.9%)patients.4) Among the study participants 44(48.9%)were smokers.5) It was observed that the symptoms of headache were present among 62 (68.9%) patients followed by weakness in 57 (63.3%), altered consciousness in 52 (57.8%) and vomiting in 46 (51.1%).6) Most of the patients were having score 2 according to Modified Rankin scale after 4 weeks follow up.Score 2 seen in 34 (37.8%)patients followed by score 1 in 27(30%), score 3 in 18 (20%), score 4 in 9(10%) and score 5 in 2 (2.2%) patients.7) In our study the mean age is 63.3 years, NIHHS score is 10, PC-ASPECT is 7.2 and modified Rankin scale score is 2. 8) The correlation of PC-ASPECT, NIHHS and modified Rankin score was observed.9) The mean NIHHS is 17.43 for PC-ASPECT score <7 score, mean NIHHS is 7.81 for PC-ASPECT score >7 and above.10) The mean modified rank in score is 3.52 for PC-ASPECT score <7, mean modified rank in score is 1.75 for PC-ASPECT score >7.11) So our conclusion is that patients with low value of PC-ASPECT score (<7), present with higher value of NIHSS score and have higher value of Modified Rankin scoreunfavourable outcome.And the patients with high value of PC-ASPECT score (>7), present with lower value of NIHSS score and low value of Modified Rankin score-favourable outcome.Inference: The present study concludes that the PC-ASPECTS and baseline NIHSS help physicians to predict an unfavourable outcome, both individually and in combination.In addition to the effect of aging, gender, co-morbidity like hypertension, diabetes, addiction factors like smoking a PC-ASPECTS of 7 was the strongest predictor of unfavorable outcomes in our univariate and multivariate models.The functional outcomes were assessed at day 30 according to the Modified Rankin Scale (MRS), a standardized functional outcome assessment tool.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».