title: External validation of the ASTRAL score to predict 3- and 12-month functional outcome in the China National Stroke Registry.
abstract: OBJECTIVE
  The ASTRAL score was recently introduced as a prognostic tool for acute ischemic stroke. It predicts 3-month outcome reliably in both the derivation and the validation European cohorts. We aimed to validate the ASTRAL score in a Chinese stroke population and moreover to explore its prognostic value to predict 12-month outcome.
  
  
  METHODS
  We applied the ASTRAL score to acute ischemic stroke patients admitted to 132 study sites of the China National Stroke Registry. Unfavorable outcome was assessed as a modified Rankin Scale score >2 at 3 and 12 months. Areas under the curve were calculated to quantify the prognostic value. Calibration was assessed by comparing predicted and observed probability of unfavorable outcome using Pearson correlation coefficient.
  
  
  RESULTS
  Among 3755 patients, 1473 (39.7%) had 3-month unfavorable outcome. Areas under the curve for 3 and 12 months were 0.82 and 0.81, respectively. There was high correlation between observed and expected probability of unfavorable 3- and 12-month outcome (Pearson correlation coefficient: 0.964 and 0.963, respectively).
  
  
  CONCLUSIONS
  ASTRAL score is a reliable tool to predict unfavorable outcome at 3 and 12 months after acute ischemic stroke in the Chinese population. It is a useful tool that can be readily applied in clinical practice to risk-stratify acute stroke patients.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Gaifen
authors.initials: G
authors.lastname: Liu
authors.forename: George
authors.initials: G
authors.lastname: Ntaios
authors.forename: Huaguang
authors.initials: H
authors.lastname: Zheng
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.forename: Patrik
authors.initials: P
authors.lastname: Michel
authors.forename: David Zheng
authors.initials: DZ
authors.lastname: Wang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Jiming
authors.initials: J
authors.lastname: Fang
authors.forename: Vasileios
authors.initials: V
authors.lastname: Papavasileiou
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.forename: Kehui
authors.initials: K
authors.lastname: Dong
authors.forename: Chunxue
authors.initials: C
authors.lastname: Wang
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002545:Brain Ischemia / Q000175:diagnosis* / Q000503:physiopathology; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome