Application of three scoring methods in screening of ischemic stroke complicated with atrial fibrillation / 中国脑血管病杂志

ABSTRACT

Objective To explore the clinical application values of the score for the targeting of atrial fibrillation (STAF) and left atrial diameter (L),age (A),diagnosis of stroke or TIA (D),and smoking one year before onset (S) (LADS) and acute stroke atrial fibrillation score (ASAS) (including 4 indicatorsage,National Institutes of Health Stroke Scale [NIHSS] score,left atrial enlargement,and vascular etiology) in the screening of patients with ischemic stroke complicated with atrial fibrillation.Methods From April 2016 to April 2017,the clinical and imaging data of 317 patients with acute ischemic stroke admitted to the Department of Neurology,the Second Affiliated Hospital of Guangzhou Medical University were analyzed retrospectively.The patients were divided into either an atrial fibrillation group (n =56) or a non-atrial fibrillation group (n =261) according to whether they had atrial fibrillation or not.The relative clinical data including gender,age,past history,NIHSS score,echocardiographic results,and cerebrovascular assessment were collected.STAF,LADS,and ASAS scores were performed in all patients,the receiver operating characteristic (ROC) curve was drawn,the area under the curve was calculated,and the sensitivity,specificity,and accuracy of the 3 methods for predicting ischemic stroke with atrial fibrillation were compared.Results Compared with the non-atrial fibrillation group,the differences were statistically significant in age (69 ± 11 years vs.62 ± 12 years),NIHSS scores (8.2 ± 1.3 vs.4.4 ± 0.3),and internal diameter of left atrium (42.3 ± 6.8 mm vs.31.7 ± 2.5 mm) in the atrial fibrillation group (t =2.99,3.38,and 6.32,respectively,all P ＜ 0.01).The area under the curve of STAF score for the diagnosis of ischemic stroke complicated with atrial fibrillation was 0.801.The optimal cut-off point was STAF ≥5,the sensitivity was 58.9％,specificity was 81.2％,and accuracy was 77.3％.The area under the curve of LADS score for diagnosis of atrial fibrillation was 0.846,the optimal cut-off point was LADS ≥ 4,the sensitivity was 66.1％,specificity 83.5 ％,and accuracy was 80.4％.The area under the curve of pr (ASAS) score for diagnosis of ischemic stroke complicated with atrial fibrillation was 0.835,the optimal cut-off point was pr (ASAS) ≥0.09,the sensitivity was 85.7％,specificity 56.7％,and accuracy was 61.8％.The sensitivity,specificity and accuracy of the three scoring methods were statistically significant (x2 =10.308,59.685,and 32.054,respectively,all P ＜ 0.01).Conclusion The accuracy of LADS ≥ 4 is the highest in screening of acute ischemic stroke complicated with atrial fibrillation