A study on the rating scale selection of ischemic stroke subtypes according to TOAST classification / 中国医师杂志

ABSTRACT

Objective To investigate the clinical rating scale appropriate to evaluate neurological impairment of ischemic stroke subtypes classified by Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Methods 289 cases of hospitalized patients with ischemic stroke in neurological wards of the first affiliated hospital of Dalian medical university from December 1,2007 to December 31, 2009 were analyzed prospectively. Results The component ratio of ischemic stroke subtypes on the basis of TOAST etiological classification were as follows: UND (36.6%) was the largest, SAO (29.8%) followed,OC (1.7%) was the lowest. In three-month mortality, CE (15.5%) was the most, LAA (11.8%) followed, SAO (1.2%) was the lowest. In three-month relapse rate, LAA (17.6%) was the most, CE (8.6%) followed, SAO (2.4%) was the lowest. The best validity of scale assessment about LAA, CE,UND, SAO subtypes were MESSS (-0.812), ESS (0.816), NIHSS (-0.807), NIHSS (-0.795) respectively, both reliability and operability were set as medium. Conclusion In ischemic stroke subtypes classified by TOAST criteria, UND had the highest incidence (SAO has the highest incidence in the specific etiology), CE mortality was the highest, LAA had the highest rate of recurrence, SAO mortality and relapse rate were the lowest. In ischemic stroke subtypes classified by TOAST criteria, MESSS was the most suitable scale for LAA, the most appropriate scale for CE was ESS, the most appropriate scale for UND, and the SAO was NIHSS.