Chander et al reported the CHANGE score for prediction of cognitive impairment after ischemic stroke. The authors are from the National Neuroscience Institute (Singapore), The Chinese University of Hong Kong, Prince of Wales Hospital (Hong Kong), and Duke-NUS Medical School (Singapore).
CHANGE is acronym based on the first letter of the 5 parameters.
Parameters:
(1) chronic lacunes (on FLAIR sequences)
(2) hyperintensities in white matter regions
(3) age
(4) non-lacunar cortical infarct, acute
(5) global cortical atrophy
(6) education in years
Parameter
Finding
Points
chronic lacunes
0 or 1
0
>= 2
2
hyperintensities
none or mild
0
moderate
1
severe
2
age
< 50 years
0
50 to 64.99 years
2
>= 65 years
4
non-lacunar cortical infarct
0
0
1
1
>=2
2
global cortical atrophy
none
0
mild
1
moderate to severe
2
education
>= 6 years
0
< 6 years
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• A score >= 7 has a sensitivity of 74% and specificity of 73% for cognitive change.
Performance:
• The area under the ROC curve ranges from 0.74 to 0.82 in different cohorts.
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