Predicting outcome after acute ischemic stroke

Objective: To externally validate two prognostic models predicting functional outcome and survival 100 days after acute ischemic stroke. Methods: Using prospectively collected data from 1,470 patients, the authors evaluated two previously developed models. Model I predicts incomplete functional recovery (Barthel Index <95) vs complete functional recovery with 11 variables, whereas model II predicts mortality vs survival with 3 variables. On admission to a participating hospital, patients were registered prospectively and included according to defined criteria. Within 72 hours, predictive variables under investigation were assessed. Follow-up was performed 100 days after the event. Results: Model I correctly predicted 68.1% of the patients who had incompletely recovered or had died and 85.7% of the completely recovered patients, model II 46.9% of the patients who had died and 95.9% of the surviving patients. Both models performed better than the treating physicians’ predictions made within 72 hours after admission. Conclusion: The resulting prognostic models are useful to correctly stratify treatment groups in clinical trials and to accurately predict the distribution of endpoint variables.