Article

OBJECTIVE: To identify any externally validated prognostic model for predicting
outcome in unselected populations following acute stroke comprising variables
feasible for collection in routine care. DATA SOURCES: Searches were run in
MEDLINE, EMBASE, CINAHL, PsycInfo, AMED and ISI Web of Science with no limits on
publication date or language. METHODS: Any study describing the
development or external validation of a discernible prognostic model to predict
any valid outcome following acute stroke was included. Papers were retained if
they met pre-specified inclusion criteria identified from previous reviews and
pertinent discussion papers. Data extraction focused on methodological quality of
model development, generalizability and feasibility of variable collection. Model
performance was examined through consideration of external validation studies.
RESULTS: Seventeen externally validated models were identified from 43 papers
fulfilling inclusion criteria. Quality of studies describing model development
was variable and model performance in external validation studies was generally
poor. Models were generally constructed through secondary use of randomized trial
or stroke database data. Prognostic variables broadly encompassed markers of
stroke severity, pre-stroke function and comorbidities. One model that fulfilled
the review criteria and had extensive external validation in a range of
post-stroke populations was identified (the Six Simple Variables model).
CONCLUSION: The Six Simple Variables model performed well in six external
validation studies, although prediction of outcome in patients with milder
strokes was less reliable. Other models identified in this review have been
developed using robust methodology but comprise more complex clinical variables
which may limit their utility in routine stroke care.

Langue : ANGLAIS