iScore for predicting institutional care after ischemic stroke: a population-based study

J Stroke Cerebrovasc Dis. 2015 Mar;24(3):694-8. doi: 10.1016/j.jstrokecerebrovasdis.2014.11.010. Epub 2015 Jan 16.

Abstract

Background: We assessed whether the iScore could predict the need for poststroke institutional care.

Methods: Patients with acute ischemic stroke living in Dijon, France, were recorded between 2006 and 2011, using a population-based stroke registry. The iScore was calculated for each patient. A logistic regression model was used to assess the performance of the iScore for predicting the need for placement in a care institution. The discrimination and calibration of the model were assessed using the c statistic and the Hosmer-Lemeshow goodness-of-fit test, respectively.

Results: Of the 1199 patients recorded, 124 were excluded because of early death and 95 because of missing for variables included in the iScore. Of the remaining 980 patients, 522 (53.3%) returned home and 458 (46.7%) required placement in a care institution. The median iScore was 123 (interquartile range, 97-148), and the proportion of patients who required placement in a care institution increased with each quintile of risk score. The discrimination of the model was good with a c statistic of .75 (95% confidence interval, .72-.78), as was calibration (P = .35).

Conclusions: The iScore could be useful for predicting the need for placement in a care institution in ischemic stroke patients. Further studies are required to confirm this finding.

Keywords: Stroke; discharge planning; epidemiology; predictors; stroke outcome; stroke registry.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / diagnosis
  • Brain Ischemia / epidemiology
  • Brain Ischemia / physiopathology
  • Brain Ischemia / psychology
  • Brain Ischemia / therapy*
  • Decision Support Techniques*
  • Female
  • France / epidemiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Nursing Homes*
  • Patient Care Planning*
  • Patient Discharge*
  • Predictive Value of Tests
  • Prognosis
  • Registries
  • Rehabilitation Centers*
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / epidemiology
  • Stroke / physiopathology
  • Stroke / psychology
  • Stroke / surgery*