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External validation of the A2DS2 score to predict stroke-associated pneumonia in a Chinese population: a prospective cohort study.


ABSTRACT:

Background and purpose

The A2DS2 score was recently developed from the Berlin Stroke Registry for predicting in-hospital pneumonia after acute ischemic stroke and performed well in an external validation in the North-west Germany Stroke Registry. It could be a useful tool for risk stratification in clinical practice or stroke trials. We aimed to prospectively validate the predictive value of A2DS2 score in a Chinese stroke population.

Methods

The prognostic model was used to predict stroke-associated pneumonia (SAP) from Henan Province Stroke Registry (HNSR) in which data were prospectively collected. The receiver-operating characteristic curves were plotted, and the C statistics were calculated to assess the discrimination ability. The Hosmer-Lemeshow goodness-of-fit test and the plot of observed versus predicted SAP risk were used to assess model calibration.

Results

Among 1142 eligible patients, the overall in-hospital SAP was 18.8%, which ranged from 9.0% in patients with lower A2DS2 scores (0-4) to 65.0% in those with higher scores of 5 to 10 (P for trend <0.001). The C statistic was 0.836 (95% confidence interval, 0.803-0.868) through the A2DS2 score, suggesting excellent discrimination in the HNSR. The A2DS2 score also showed excellent calibration (Cox and Snell R2?=?0.243) in the external validation sample from the HNSR.

Conclusions

The A2DS2 score could reliably predict in-hospital SAP in Chinese stroke patients. It might be helpful for the assessment of increased risk monitoring and prophylactic treatment in identified high-risk patients for SAP in clinical routine.

SUBMITTER: Li Y 

PROVIDER: S-EPMC4192306 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

External validation of the A2DS2 score to predict stroke-associated pneumonia in a Chinese population: a prospective cohort study.

Li Yapeng Y   Song Bo B   Fang Hui H   Gao Yuan Y   Zhao Lu L   Xu Yuming Y  

PloS one 20141009 10


<h4>Background and purpose</h4>The A2DS2 score was recently developed from the Berlin Stroke Registry for predicting in-hospital pneumonia after acute ischemic stroke and performed well in an external validation in the North-west Germany Stroke Registry. It could be a useful tool for risk stratification in clinical practice or stroke trials. We aimed to prospectively validate the predictive value of A2DS2 score in a Chinese stroke population.<h4>Methods</h4>The prognostic model was used to predi  ...[more]

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