Value of acute physiology and chronic health condition evaluation Ⅱand National Institute of Health Stroke Scale in evaluating outcome of patients with acute cerebral infarction / 临床神经病学杂志

ABSTRACT

Objective To evaluate the value of acute physiology and chronic health condition evaluation Ⅱ(APACHEⅡ) and National Institute of Health Stroke Scale(NIHSS) score in evaluating outcome of patients with acute cerebral infarction(ACI).Methods 399 patients with ACI were scored by APACHEⅡ and NIHSS in 3 d after onset.Prognosis judgement accorded to the patients survival or death during 28 d after onset.Area under of the receiver operator characteristic(ROC) curves was used to scale the ability of APACHEⅡ and NIHSS scoring systems evaluating severity and predicting outcomes of patients with ACI to find best cut-off points of the two scoring systems.Using discriminant analysis method to analysis the two scoring systems and estabished mathematical functional equation to calculate accuracy.Results For prognosis of patients with ACI,the areas under ROC curves were 0.835 and 0.822,and the best cut-off points were 12 and 10 respectively for APACHEⅡand NIHSS.The accuracy rates of APACHEⅡand NIHSS were 74.5% and 76.9%,respectively.The accuracy rate of APACHEⅡcombined NIHSS was 85.5%.Conclusions The APACHEⅡand NIHSS score systems have satisfactory discrimination for patients witn ACI,The predictive accuracy may improve if APACHEⅡ is combined with NIHSS.