Work

Stratifying the Utility of Transthoracic Echocardiography for Ischemic Stroke using a Risk Score

Year: 2025

Type: article

Abstract: INTRODUCTION: Inpatient transthoracic echocardiography (TTE) is considered to be an important part of secondary prevention in acute ischemic stroke, but can be a barrier to discharge. The goal of the study was to generate a risk score to assess which patients will benefit from a TTE in the inpatient setting. METHODS: The training data set consisted of all 874 patients from the UW Health Comprehensive Stroke Registry admitted for acute ischemic stroke/transient ischemic attack (TIA) from 2017 to 2018 that received a TTE. A validation data set of 200 stroke patients was used from the Indiana University Stroke Registry. Using the training data, a modified logistic regression model was developed with simplified coefficients and a limited number of variables. The area under the receiver operator characteristic curve (AUC) was compared between different models and between the training and validation data sets. RESULTS: OHA, mean AUC on the training data across five-fold cross validation was 0.78 (95% CI, 0.76-0.80). The model consisted of six variables, and one point was awarded for each: atrial fibrillation, large artery atherosclerosis, large vessel occlusion, obesity, prior antihypertensive medication use, and if the patient's age was 18-39 or ≥70. Risk of positive findings was 6.2% for score of 0, 23.1% for score of 1, 57.4% for score of 2, 85.8% for score of 3, 96.4% for score of 4, and 99.2% for score of 5 or greater. When tested on the external validation data set, AUC was 0.73 and demonstrated to not be significantly different than the AUC for the training data set. CONCLUSIONS: OHA model is a clinical tool which can stratify which patients admitted for acute ischemic stroke/TIA are more likely to benefit from inpatient TTEs.

Source: Cerebrovascular Diseases

DOI: 10.1159/000544746

Authors: Neel D. Jani, Haley Basinger, Ann M. Jones, Justin A. Sattin, Aaron F. Struck

Institutions: University of Wisconsin–Madison, Indiana University School of Medicine, William S. Middleton Memorial Veterans Hospital

Language: English

Topic: Acute Ischemic Stroke Management

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W4410118460