A Validation of the Essen Stroke Risk Score in Outpatients with Ischemic Stroke.
BACKGROUND
Little is known about the predictive accuracy of the Essen Stroke Risk Score (ESRS) for Chinese stroke outpatients. Our goal was to perform an external validation of the ESRS using a large multicenter cohort of outpatients with ischemic stroke (IS).


METHODS
We estimated the 1-year cumulative event rates for both recurrent stroke and combined vascular events for patients in different ESRS categories using data from a prospective cohort of 3316 outpatients with IS admitted to 18 hospitals in China. In addition, we evaluated the predictive accuracy of the ESRS for both recurrent stroke and combined vascular events using C statistic.


RESULTS
In the nonatrial fibrillation IS outpatients, the cumulative 1-year event rate was 2.47% (95% confidence interval [CI], 1.97%-3.06%) for recurrent stroke and 4.32% (95% CI, 3.65%-5.06%) for combined vascular events. The event rates were significantly higher in patients in higher ESRS categories. The ESRS had a predictive accuracy of .63 (.57-.69) for recurrent stroke and .63 (.58-.68) for combined vascular events.


CONCLUSIONS
Among the Chinese outpatients with IS, the ESRS was able to stratify the risk of both recurrent stroke and combined vascular events equally well. A prediction model suitable for Chinese IS populations is needed.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Pan
P
Chen
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
Yi
Y
Liu
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yilong
Y
Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Anxin
A
Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Huaguang
H
Zheng
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xingquan
X
Zhao
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China. Electronic address: yanas@139.com.
Aoshuang
A
Yan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: yongjunwang1962@gmail.com.
Yongjun
Y
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002545:Brain Ischemia / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology*; D013997:Time Factors; D055815:Young Adult
Ischemic stroke; outpatients; the Essen Stroke Risk Score; validation