Saposnik et al developed the IScore to predict mortality following hospitalization for an acute ischemic stroke. The authors are the Canadian Stroke Network and Stroke Outcomes Research Canada Working Group.
Patient selection: ischemic stroke
Parameters:
(1) age
(2) gender
(3) stroke severity using the Canadian Neurological Scale (CNS)
(4) stroke subtype
(5) preadmission disability status
(6) glucose on admission in mmol/L
(7) history of atrial fibrillation
(8) history of congestive heart failure (CHF)
(9) history of myocardial infarction
(10) current smoker
(11) cancer
(12) renal dialysis (indicative of renal dysfunction)
|
Parameter |
Finding |
Points A |
Points B |
|---|---|---|---|
|
age in years |
|
|
|
|
gender |
female |
0 |
0 |
|
|
male |
10 |
5 |
|
stroke severity |
mild (>= 8) |
0 |
0 |
|
|
moderate (5 to 7) |
40 |
25 |
|
|
severe (1 to 4) |
65 |
40 |
|
|
coma (0) |
105 |
70 |
|
stroke subtype |
lacunar |
0 |
0 |
|
|
nonlacunar |
30 |
15 |
|
|
unknown |
35 |
20 |
|
preadmission status |
independent |
0 |
0 |
|
|
dependent |
15 |
20 |
|
glucose on admission |
< 7.5 mmol/L |
0 |
0 |
|
|
>= 7.5 mmol/L |
15 |
10 |
|
atriial fibrillation |
no |
0 |
0 |
|
|
yes |
10 |
5 |
|
CHF |
no |
0 |
0 |
|
|
yes |
10 |
10 |
|
myocardial infarction |
no |
0 |
0 |
|
|
yes |
0 |
5 |
|
current smoker |
no |
0 |
0 |
|
|
yes |
0 |
5 |
|
cancer |
no |
0 |
0 |
|
|
yes |
10 |
15 |
|
renal dialysis |
no |
0 |
0 |
|
|
yes |
35 |
40 |
total score for 30-day mortality risk =
= SUM(points from the A column)
total score for 1-year mortality risk =
= SUM(points from the B column)
Interpretation:
• minimum score: age of the patient
• maximum score for 30-day mortality: age plus 230
• maximum score for 1-year mortality: age plus 205
• The higher the score the greater the mortality.
|
30-Day Score |
30-Day Mortality |
|---|---|
|
59 to 110 |
1.2 |
|
111 to 120 |
2.9 |
|
121 to 130 |
4.3 |
|
131 to 140 |
6.0 |
|
141 to 150 |
9.4 |
|
151 to 160 |
13 |
|
161 to 170 |
14 |
|
171 to 180 |
22 |
|
181 to 190 |
27 |
|
191 to 200 |
38 |
|
201 to 210 |
40 |
|
211 to 220 |
58 |
|
221 to 240 |
64 |
|
241 to 260 |
83 |
|
261 to 270 |
88 |
|
271 to 280 |
75 (90 predicted) |
|
281 to 285 |
100 |
|
1-Year Score |
1-Year Mortality |
|---|---|
|
59 to 80 |
1.8 |
|
81 to 90 |
4.0 |
|
91 to 100 |
7.6 |
|
101 to 110 |
12 |
|
111 to 120 |
19 |
|
121 to 130 |
25 |
|
131 to 140 |
35 |
|
141 to 150 |
47 |
|
151 to 160 |
56 |
|
161 to 170 |
63 |
|
171 to 190 |
78 |
|
191 to 200 |
98 (87 predicted) |
|
201 to 220 |
91 |
|
>= 221 |
100 |
Specialty: Neurology
ICD-10: ,
