title: Developing predictive models of excellent and devastating outcome after stroke.
abstract: BACKGROUND
  models to predict functional status post-stroke have utility in balancing groups in randomised trials, for outcome comparison between stroke centres and may assist in outcome prediction. This study aimed to develop models of both excellent [modified Rankin score (mRS) 0-1] and devastating outcomes (mRS of 5-6).
  
  
  METHODS
  patients admitted with ischaemic or haemorrhagic stroke in 2001-02 to the Halifax Infirmary, Canada, were enrolled. Sixteen clinical variables from the first neurological assessment and six radiological variables from the acute CT scan were used to the model outcome at 6 months.
  
  
  RESULTS
  five hundred and thirty-eight stroke patients were enrolled. Thirty per cent had an excellent outcome and 30% had a devastating outcome. Three models of the excellent outcome were developed [area under the receiver operator curve (AUC) 0.866-882] including the variables age, pre-stroke functional status, stroke severity, ability to lift both arms, walk independently, normal verbal Glasgow Coma Scale and leukoaraiosis. Predictive models of the devastating outcome (AUC of 0.859-0.874) included additional variables living alone pre-stroke and total anterior circulation stroke. The simplest models of both outcomes were externally validated (AUC of 0.856-0.885).
  
  
  CONCLUSIONS
  this study demonstrates new externally validated predictive models of both excellent and devastating outcomes. Leukoaraiosis was the only independent radiological predictor of both outcomes. Living alone pre-stroke predicted devastating outcome post-stroke.
authors.affiliation: Department of Neurology, Aberdeen Royal Infirmary, Ward 40 Aberdeen Royal Infirmary Foresterhill, Aberdeen AB252ZN, UK. johnreid1@nhs.net
authors.forename: John M
authors.initials: JM
authors.lastname: Reid
authors.forename: Dingwei
authors.initials: D
authors.lastname: Dai
authors.forename: Christine
authors.initials: C
authors.lastname: Christian
authors.forename: Yvette
authors.initials: Y
authors.lastname: Reidy
authors.forename: Carl
authors.initials: C
authors.lastname: Counsell
authors.forename: Gord J
authors.initials: GJ
authors.lastname: Gubitz
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Phillips
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016009:Chi-Square Distribution; D003661:Decision Support Techniques; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000000981:diagnostic imaging; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009460:Neurologic Examination; D009674:Nova Scotia; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012847:Single Person; D020521:Stroke / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed