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Abstract：
BACKGROUND: Patient outcome after stroke is frequently assessed with clinical scales such as the modified Rankin Scale score (mRS). Days alive and out of hospital at 90 days (DAOH-90), which measures survival, time spent in hospital or rehabilitation settings, readmission and institutionalization, is an objective outcome measure that can be obtained from large administrative data sets without the need for patient contact. We aimed to assess the comparability of DAOH with mRS and its relationship with other prognostic variables after acute stroke reperfusion therapy.
RESULTS: Consecutive patients with ischemic stroke treated with intravenous thrombolysis or endovascular thrombectomy were analyzed. DAOH-90 was calculated from a national minimum data set, a mandatory nationwide administrative database. mRS score at day 90 (mRS-90) was assessed with in-person or telephone interviews. The study included 1278 patients with ischemic stroke (714 male, median age 70 [59-79], median National Institutes of Health Stroke Scale score 14 [9-20]). Median DAOH-90 was 71 [29-84] and median mRS-90 score was 3 [2-5]. DAOH-90 was correlated with admission National Institutes of Health Stroke Scale score (Spearman rho -0.44, P<0.001) and Alberta Stroke Program Early CT [Computed Tomography] Score (Spearman rho 0.24, P<0.001). There was a strong association between mRS-90 and DAOH-90 (Spearman rho correlation -0.79, P<0.001). Area under receiver operating curve for predicting mRS score >0 was 0.86 (95% CI, 0.84-0.88), mRS score >1 was 0.88 (95% CI, 0.86-0.90) and mRS score >2 was 0.90 (95% CI, 0.89-0.92).
CONCLUSIONS: In patients with stroke treated with reperfusion therapies, DAOH-90 shows reasonable comparability to the more established outcome measure of mRS-90. DAOH-90 can be readily obtained from administrative databases and therefore has the potential to be used in large-scale clinical trials and comparative effectiveness studies.
RESULTS: Consecutive patients with ischemic stroke treated with intravenous thrombolysis or endovascular thrombectomy were analyzed. DAOH-90 was calculated from a national minimum data set, a mandatory nationwide administrative database. mRS score at day 90 (mRS-90) was assessed with in-person or telephone interviews. The study included 1278 patients with ischemic stroke (714 male, median age 70 [59-79], median National Institutes of Health Stroke Scale score 14 [9-20]). Median DAOH-90 was 71 [29-84] and median mRS-90 score was 3 [2-5]. DAOH-90 was correlated with admission National Institutes of Health Stroke Scale score (Spearman rho -0.44, P<0.001) and Alberta Stroke Program Early CT [Computed Tomography] Score (Spearman rho 0.24, P<0.001). There was a strong association between mRS-90 and DAOH-90 (Spearman rho correlation -0.79, P<0.001). Area under receiver operating curve for predicting mRS score >0 was 0.86 (95% CI, 0.84-0.88), mRS score >1 was 0.88 (95% CI, 0.86-0.90) and mRS score >2 was 0.90 (95% CI, 0.89-0.92).
CONCLUSIONS: In patients with stroke treated with reperfusion therapies, DAOH-90 shows reasonable comparability to the more established outcome measure of mRS-90. DAOH-90 can be readily obtained from administrative databases and therefore has the potential to be used in large-scale clinical trials and comparative effectiveness studies.
摘要：
背景：通常使用临床量表如改良Rankin量表评分（mRS）评估卒中后患者的预后。存活天数，90天出院（DAOH-90），衡量生存，在医院或康复场所度过的时间，重新接纳和制度化，是一种客观的结果度量，可以从大型管理数据集中获得，而无需与患者联系。我们旨在评估急性卒中再灌注治疗后DAOH与mRS的可比性及其与其他预后变量的关系。
结果：分析连续接受静脉溶栓或血管内血栓切除术治疗的缺血性卒中患者。DAOH-90是根据国家最低数据集计算的，强制性的全国性行政数据库。第90天的mRS评分（mRS-90）通过面对面或电话访谈进行评估。该研究包括1278例缺血性卒中患者（714例男性，中位年龄70[59-79]，美国国立卫生研究院卒中量表中位数评分14[9-20]）。DAOH-90中位数为71[29-84]，mRS-90中位数为3[2-5]。DAOH-90与美国国立卫生研究院卒中量表评分（Spearmanrho-0.44，P<0.001）和Alberta卒中项目早期CT[计算机断层扫描]评分（Spearmanrho0.24，P<0.001）相关。mRS-90和DAOH-90之间有很强的相关性（Spearmanrho相关性-0.79，P<0.001）。预测mRS评分>0的受试者工作曲线下面积为0.86(95%CI,0.84-0.88),mRS评分>1为0.88(95%CI,0.86-0.90),mRS评分>2为0.90(95%CI,0.89-0.92)。
结论：在接受再灌注治疗的中风患者中，DAOH-90与mRS-90的更确定的结果测量显示出合理的可比性。DAOH-90可以很容易地从管理数据库中获得，因此具有用于大规模临床试验和比较有效性研究的潜力。
结果：分析连续接受静脉溶栓或血管内血栓切除术治疗的缺血性卒中患者。DAOH-90是根据国家最低数据集计算的，强制性的全国性行政数据库。第90天的mRS评分（mRS-90）通过面对面或电话访谈进行评估。该研究包括1278例缺血性卒中患者（714例男性，中位年龄70[59-79]，美国国立卫生研究院卒中量表中位数评分14[9-20]）。DAOH-90中位数为71[29-84]，mRS-90中位数为3[2-5]。DAOH-90与美国国立卫生研究院卒中量表评分（Spearmanrho-0.44，P<0.001）和Alberta卒中项目早期CT[计算机断层扫描]评分（Spearmanrho0.24，P<0.001）相关。mRS-90和DAOH-90之间有很强的相关性（Spearmanrho相关性-0.79，P<0.001）。预测mRS评分>0的受试者工作曲线下面积为0.86(95%CI,0.84-0.88),mRS评分>1为0.88(95%CI,0.86-0.90),mRS评分>2为0.90(95%CI,0.89-0.92)。
结论：在接受再灌注治疗的中风患者中，DAOH-90与mRS-90的更确定的结果测量显示出合理的可比性。DAOH-90可以很容易地从管理数据库中获得，因此具有用于大规模临床试验和比较有效性研究的潜力。
