Using Radiological Data to Estimate Ischemic Stroke Severity

dc.contributor.authorSico, Jason J.
dc.contributor.authorPhipps, Michael S.
dc.contributor.authorConcato, John
dc.contributor.authorBrandt, Cynthia
dc.contributor.authorWells, Carolyn K.
dc.contributor.authorLo, Albert C.
dc.contributor.authorNadeau, Stephen E.
dc.contributor.authorWilliams, Linda S.
dc.contributor.authorGorman, Mark
dc.contributor.authorBoice, John L.
dc.contributor.authorBravata, Dawn M.
dc.contributor.departmentDepartment of Neurology, IU School of Medicineen_US
dc.date.accessioned2016-11-17T14:24:46Z
dc.date.available2016-11-17T14:24:46Z
dc.date.issued2016-04
dc.description.abstractBackground Risk-adjusted poststroke mortality has been proposed for use as a measure of stroke care quality. Although valid measures of stroke severity (e.g., the National Institutes of Health Stroke Scale [NIHSS]) are not typically available in administrative datasets, radiology reports are often available within electronic health records. We sought to examine whether admission head computed tomography data could be used to estimate stroke severity. Materials and Methods Using chart review data from a cohort of acute ischemic stroke patients (1998-2003), we developed a radiographic measure ([BIS]) of stroke severity in a two-third development set and assessed in a one-third validation set. The retrospective NIHSS was dichotomized as mild/moderate (<10) and severe (≥10). We compared the association of this radiographic score with NIHSS and in-hospital mortality at the patient level. Results Among 1348 stroke patients, 86.5% had abnormal findings on initial head computed tomography. The c-statistic for the BIS for modeling severe stroke (development, .581; validation, .579) and in-hospital mortality (development, .623; validation, .678) were generated. Conclusions Although the c-statistics were only moderate, the BIS provided significant risk stratification information with a 2-variable score. Until administrative data routinely includes a valid measure of stroke severity, radiographic data may provide information for use in risk adjustment.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationSico, J. J., Phipps, M. S., Concato, J., Brandt, C., Wells, C. K., Lo, A. C., … Bravata, D. M. (2016). Using Radiological Data to Estimate Ischemic Stroke Severity. Journal of Stroke and Cerebrovascular Diseases, 25(4), 792–798. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.12.002en_US
dc.identifier.urihttps://hdl.handle.net/1805/11471
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.isversionof10.1016/j.jstrokecerebrovasdis.2015.12.002en_US
dc.relation.journalJournal of Stroke and Cerebrovascular Diseasesen_US
dc.rightsPublisher Policyen_US
dc.sourceAuthoren_US
dc.subjectischemic strokeen_US
dc.subjectimagingen_US
dc.subjectCT scanen_US
dc.titleUsing Radiological Data to Estimate Ischemic Stroke Severityen_US
dc.typeArticleen_US
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