Predictive value of the APACHE Ⅳ scoring system for ischemic stroke severity:a retrospective observational study from a large database / 中风与神经疾病杂志

ABSTRACT

@#Objective　To investigate the prognostic value of independent risk factors for ischemic stroke (IS) and acute physiological and chronic health status scoring system Ⅳ (APACHE Ⅳ) in predicting the severity of IS.Methods　We used individual patient data (n=200859) from a national multicenter cohort study (eICU database) to identify patients with primary diagnosis of IS (n=1934) for statistical analysis.The primary outcome was hospital mortality (HM).To evaluate the relationship between APACHE Ⅳscore and hospital mortality,binary logistic regression was used to analyze the independent predictors of HM of IS patients,and receiver operating characteristic curve (ROC curve) was used to evaluate the predictive value of APACHE Ⅳscore for the severity of ischemic stroke.Results　APACHE Ⅳscore of survival group and death group was statistically significant.(P<0.05).Binary logistic regression analysis showed that APACHE Ⅳscore was an independent risk factor for severity of IS.APACHE Ⅳscore predicted the severity of IS with an area under ROC curve of 0.770［95%CI (0.736，0.804)］.The best truncation value was 56.5,the sensitivity was 71.8%,and the specificity was 72.8%.Conclusion　APACHE Ⅳscore has certain predictive value for the severity of ischemic stroke.