title: Poor performance of stroke prognostication using Age and National Institutes of Health Stroke Scale-100 to predict 3- and 12-month outcomes of ischemic stroke in China National Stroke Registry.
abstract: BACKGROUND
  Stroke Prognostication using Age and NIH (National Institutes of Health) Stroke Scale (SPAN)-100 is a simple and easy-to-use tool for assessing the outcomes of ischemic stroke after thrombolysis. To explore its application, we evaluated SPAN-100's prognostic value in predicting 3- and 12-month outcomes in general ischemic stroke patients.
  
  
  METHODS
  We applied the SPAN-100 to ischemic stroke patients from the China National Stroke Registry. Poor outcome was defined as a modified Rankin Scale of 2-6. Discrimination of SPAN-100 was assessed by the area under the receiver-operator curves (AUC) and 95% confidence intervals (CI). We also performed an exploratory post hoc analysis of the performance of the SPAN index score using 80 as the cutoff point.
  
  
  RESULTS
  Among 11,894 ischemic stroke patients, 479 (4.0%) patients were SPAN-100 positive. The AUC of SPAN-100 for poor outcome was .54 (95% CI, .54-.54) at 3 months and .54 (95% CI, .54-.55) at 12 months, respectively. In the exploratory analysis, when 80 was used as the cutoff point of SPAN index score, the AUC for poor outcome was .66 (95% CI, .66-.67) at 3 months and .68 (95% CI, .67-.68) at 12 months, respectively.
  
  
  CONCLUSIONS
  SPAN-100 suffered from low prediction power for 3- and 12-month outcomes of ischemic stroke in Chinese population. A cutoff point of 80 may improve the performance, but none of them had an AUC above the threshold of .8 required for use in individuals.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jing
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
authors.forename: Runhua
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.affiliation: Brain Injury Translational Research Center, Duke University Medical Center, Durham, North Carolina.
authors.forename: Haichen
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
authors.forename: Gaifen
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
authors.forename: Chunxue
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China. Electronic address: yilong528@gmail.com.
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China. Electronic address: yongjunwang1962@gmail.com.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000437:Alcoholism / Q000150:complications; D044466:Asian People / Q000706:statistics & numerical data*; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D016896:Treatment Outcome
keywords: SPAN-100; ischemic stroke; outcome; prognosis