Retrospective Comparison of the Predictive Ability of SPAN-100 Index, Age, and the NIHSS Score on Acute Ischaemic Stroke 30-day Case Fatality Rate
Nigerian Society of Neurological Sciences
Background: Prognostication and risk prediction are important components of acute stroke management. Identification of acute stroke cases with an increased likelihood of adverse outcomes can promote the implementation of preventive strategies including intensified monitoring and pre-emptive interventions. The use of clinical parameters as predictors of outcome is of particular interest in our resource-limited setting. Objectives: To determine the predictive ability of the Stroke Prognostication using Age and National Institutes of Health Stroke Scale/Score (SPAN-100) index on 30-day case fatality rate (CFR) in acute ischaemic stroke (AIS) and compare this to the predictive ability of the individual components of the index. Methodology: This descriptive study retrospectively analysed data from the Lagos University Teaching Hospital Nigeria stroke database over a 30-month period. The cases were consecutive first-ever clinically overt, brain computed tomographically evident AIS, aged ≥18years, admitted within 7days of onset. The SPAN-100 index (sum of age and baseline NIHSS score) was characterized as SPAN-100 index positive (score ≥100) or negative (<100). The primary outcome of interest was 30-day all cause CFR. Results: Four hundred and twenty-one AIS cases (220 males, 201 females; mean age 60.7±13.3years) satisfied the study criteria. Three hundred and ninety-six (94.1%) were SPAN-100 negative. The 30-day CFR was significantly greater in the SPAN-100 positive AIS cases (19/25 i.e. 76.6% v. 107/396 i.e. 27%) (p=0.000; Odds ratio 8.55 (95% CI 3.33–21.98). The SPAN-100 index only fairly predicted 30-day CFR (AUC 0.74), while the NIHSS score was a good predictor of short-term outcome (AUC 0.85). Age had very poor predictive ability (AUC 0.52). Conclusion: The NIHSS score is a better predictor of short-term outcome following AIS compared to either the SPAN-100 index or patient’s age.
Stroke , Prognosis , Case fatality , Span index , Research Subject Categories::MEDICINE
Ojo OO, Okubadejo NU, Agabi PO, Daniel A, Nwazor E, Omojowolo O, Ojini FI, Danesi MA. Retrospective Comparison of the Predictive Ability of SPAN-100 Index, Age, and the NIHSS Score on Acute Ischaemic Stroke 30-day Case Fatality Rate. Journal of Clinical and Applied Neurosciences. 2017;2(2):55-62