A novel prediction score determining individual clinical outcome 3 months after juvenile stroke (PREDICT-score)

• DOI: 10.1007/s00415-024-12552-5
• Publication Date: 2024-07-31T20:02:29Z
• Authors: Verena S. Hoffmann; Sonja Schönecker; Moustafa Amin; Paul Reidler; Anna Brauer; Anna Kopczak; Silke Wunderlich; Sven Poli; Katharina Althaus; Susanne Müller; Ulrich Mansmann; Lars Kellert
• Keywords: Original Communication ; Prediction score ; 3-month outcome ; Juvenile stroke ; Predictive factors; Male; Adult; Original Communication; Age Factors; Middle Aged; Prognosis; Severity of Illness Index; 01 natural sciences; ddc:; Stroke; Ischemic Attack, Transient; Outcome Assessment, Health Care; Humans; Female; 0101 mathematics; Retrospective Studies; Ischemic Stroke

Abstract Background Juvenile strokes (< 55 years) account for about 15% of all ischemic strokes. Structured data on clinical outcome in those patients are sparse. Here, we aimed to fill this gap by systematically collecting relevant data and modeling a juvenile stroke prediction score for the 3-month functional outcome.

Methods We retrospectively integrated and analyzed clinical and outcome data of juvenile stroke and TIA patients treated at the LMU University Hospital, LMU Munich, Munich. Good outcome was defined as a modified Rankin Scale of 0–2 or return to baseline of function. We analyzed candidate predictors and developed a predictive model. Predictive abilities were inspected using Area Under the ROC curve (AUROC) and visual representation of the calibration. The model was validated internally.

Results 346 patients were included in the analysis. We observed a good outcome in n = 293 patients (84.7%). The prediction model for an unfavourable outcome had an AUROC of 89.1% (95% CI 83.3–93.1%). The model includes age NIHSS, ASPECTS, blood glucose and type of vessel occlusion as predictors for the individual patient outcome.

Conclusions Here, we introduce the highly accurate PREDICT-score for the 3-month outcome after juvenile stroke derived from clinical routine data. The PREDICT-score might be helpful in guiding individual patient decisions and designing future studies but needs further prospective validation which is already planned. Trial registration The study has been registered at https://drks.de (DRKS00024407) on March 31, 2022.