A new subtype classification of ischemic stroke based on treatment and etiologic mechanism.
A new subtype classification of ischemic stroke was developed to reflect recent therapeutic strategies as well as evolving concepts of stroke definitions and mechanisms. In 200 consecutive patients with acute ischemic stroke, the inter-rater reliability and proportion of subtypes of the new classification system were assessed and compared with those of the Trial of ORG 10172 in the Acute Stroke Treatment (TOAST) classification. The most frequent subtype of the new classification was atherothrombosis (n = 80, 40%), followed by stroke of undetermined etiology (n = 54, 27%), small artery disease (n = 33, 16.5%), cardioembolism (n = 26, 13%), and stroke of other determined etiology (n = 7, 3.5%). Three raters agreed to the stroke subtype diagnosis in 165 out of 200 cases and the overall kappa value was excellent (kappa = 0.82). The new classification system for brain infarction was easy to use and had high inter-rater reliability.
Han
Sang Won
SW
Department of Neurology, National Core Research Center for Nanomedical Technology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Kim
Seo Hyun
SH
Lee
Jong Yun
JY
Chu
Chong Kyu
CK
Yang
Jae Hoon
JH
Shin
Ha Young
HY
Nam
Hyo Suk
HS
Lee
Byung In
BI
Heo
Ji Hoe
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000473:pathology; D020766:Intracranial Embolism / Q000150:complications / Q000473:pathology; D020767:Intracranial Thrombosis / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012307:Risk Factors; D020521:Stroke / Q000145:classification* / Q000209:etiology* / Q000628:therapy