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A tool to identify patients with embolic stroke of undetermined source at high recurrence risk.

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dc.contributor.author Ntaios, George
dc.contributor.author Georgiopoulos, Georgios
dc.contributor.author Perlepe, Kalliopi
dc.contributor.author Sirimarco, Gaia
dc.contributor.author de Strambo, Davi
dc.contributor.author Eskandari, Ashraf
dc.contributor.author Nannoni, Stefania
dc.contributor.author Vemmou, Anastasia
dc.contributor.author Koroboki, Eleni
dc.contributor.author Manios, Efstathios
dc.contributor.author Rodríguez-Campello, Ana
dc.contributor.author Cuadrado-Godia, Elisa
dc.contributor.author Roquer, Jaume
dc.contributor.author Arnao, Valentina
dc.contributor.author Caso, Valeria
dc.contributor.author Pacianroni, Maurizio
dc.contributor.author Díez-Tejedor, Exuperio
dc.contributor.author Fuentes, Blanca
dc.contributor.author Rodríguez Pardo, Jorge
dc.contributor.author Sánchez-Velazco, Sara
dc.contributor.author Arauz-Gongora, Antonio
dc.contributor.author Ameriso, Sebastián Francisco
dc.contributor.author Pertierra, Lucía
dc.contributor.author Gómez Schneider, Maia Macarena
dc.contributor.author Hawkes, Maximiliano Alberto
dc.contributor.author Barboza, Miguel A.
dc.contributor.author Chavarría Cano, Beatriz
dc.contributor.author Iglesias Mohedano, Ana María
dc.contributor.author García Pastor, Andrés
dc.contributor.author Gil-Nuñez, Antonio
dc.contributor.author Putaala, Jukka
dc.contributor.author Tatlisumak, Turgut
dc.contributor.author Karagkiozi, Efstathia
dc.contributor.author Papavasileiou, Vasileios
dc.contributor.author Makaritsis, Konstantinos
dc.contributor.author Bandini, Fabio
dc.contributor.author Vemmos, Konstantinos
dc.contributor.author Michel, Patrik
dc.date.accessioned 2019-11-04T17:59:15Z
dc.date.available 2019-11-04T17:59:15Z
dc.date.issued 2019-10-29
dc.identifier.citation Ntaios G, Georgiopoulos G, Perlepe K, et al. A tool to identify patients with embolic stroke of undetermined source at high recurrence risk. Neurology. 2019;0(0). doi:10.1212/WNL.0000000000008571 en_US
dc.identifier.uri https://repositorio.fleni.org.ar/handle/123456789/97
dc.identifier.uri https://doi.org/10.1212/WNL.0000000000008571
dc.description.abstract Objective A tool to stratify the risk of stroke recurrence in patients with embolic stroke of ndetermined source (ESUS) could be useful in research and clinical practice. We aimed to determine whether a score can be developed and externally validated for the identification of patients with ESUS at high risk for stroke recurrence. Methods We pooled the data of all consecutive patients with ESUS from 11 prospective stroke registries.We performed multivariable Cox regression analysis to identify predictors of stroke recurrence. Based on the coefficient of each covariate of the fitted multivariable model, we generated an integer-based point scoring system.We validated the score externally assessing its discrimination and calibration. Results In 3 registries (884 patients) that were used as the derivation cohort, age, leukoaraiosis, and multiterritorial infarct were identified as independent predictors of stroke recurrence and were included in the final score, which assigns 1 point per every decade after 35 years of age, 2 points for leukoaraiosis, and 3 points for multiterritorial infarcts (acute or old nonlacunar). The rate of stroke recurrence was 2.1 per 100 patient-years (95% confidence interval [CI] 1.44–3.06) in patients with a score of 0–4 (low risk), 3.74 (95% CI 2.77–5.04) in patients with a score of 5–6 (intermediate risk), and 8.23 (95% CI 5.99–11.3) in patients with a score of 7–12 (high risk). Compared to lowrisk patients, the risk of stroke recurrence was significantly higher in intermediate-risk (hazard ratio [HR] 1.78, 95% CI 1.1–2.88) and high-risk patients (HR 4.67, 95% CI 2.83–7.7). The score was well-calibrated in both derivation and external validation cohorts (8 registries, 820 patients) (Hosmer-Lemeshow test χ2: 12.1 [p = 0.357] and χ2: 21.7 [p = 0.753], respectively).The area under the curve of the score was 0.63 (95% CI 0.58–0.68) and 0.60 (95% CI 0.54–0.66), respectively. Conclusions The proposed score can assist in the identification of patients with ESUS at high risk for stroke recurrence. en_US
dc.language.iso eng en_US
dc.publisher Lippincott Williams & Wilkins en_US
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Embolia en_US
dc.subject Embolism en_US
dc.subject Stroke en_US
dc.subject Accidente Cerebrovascular en_US
dc.subject Embolic Stroke of Undetermined Source en_US
dc.subject ESUS en_US
dc.subject Accidente cerebrovascular embólico de origen indeterminado en_US
dc.title A tool to identify patients with embolic stroke of undetermined source at high recurrence risk. en_US
dc.type info:eu-repo/semantics/publishedVersion
dc.type info:eu-repo/semantics/article en_US
dc.description.fil Fil: Ntaios, George.University of Thessaly. School of Health Sciences. Faculty of Medicine. Department of Internal Medicine; Grecia.
dc.description.fil Fil: Georgiopoulos, Georgios. University of Thessaly. School of Health Sciences. Faculty of Medicine. Department of Internal Medicine; Grecia.
dc.description.fil Fil: Perlepe, Kalliopi.University of Thessaly. School of Health Sciences. Faculty of Medicine. Department of Internal Medicine; Grecia.
dc.description.fil Fil: Sirimarco, Gaia. Laussane University Hospital Department of Clinical Neurosciences, Neurology Service Stroke Center; Suiza.
dc.description.fil Fil: de Strambo, Davi.Laussane University Hospital Department of Clinical Neurosciences, Neurology Service Stroke Center; Suiza.
dc.description.fil Fil: Eskandari, Ashraf.Laussane University Hospital Department of Clinical Neurosciences, Neurology Service Stroke Center; Suiza.
dc.description.fil Fil: Nannoni, Stefania.Laussane University Hospital Department of Clinical Neurosciences, Neurology Service Stroke Center; Suiza.
dc.description.fil Fil: Vemmou, Anastasia. Alexandra Hospital.Medical School of Athens. Department of Clinical Therapeutics; Grecia.
dc.description.fil Fil: Koroboki, Eleni. Alexandra Hospital.Medical School of Athens. Department of Clinical Therapeutics; Grecia.
dc.description.fil Fil: Manios, Efstathios. Alexandra Hospital.Medical School of Athens. Department of Clinical Therapeutics; Grecia.
dc.description.fil Fil: Rodríguez-Campello, Ana.Hospital del Mar. Neurology Dept.; España
dc.description.fil Fil: Cuadrado-Godia, Elisa. Hospital del Mar Medical Research Institute. Neurology Dept.; España
dc.description.fil Fil: Roquer, Jaume. Hospital del Mar Medical Research Institute. Neurology Dept.; España
dc.description.fil Fil: Arnao, Valentina. University of Palermo. Department of Experimental Biomedicine and Clinical Neurosciences; Italia.
dc.description.fil Fil: Caso, Valeria. University of Perugia. Stroke Unit and Division of Internal and Cardiovascular Medicine; Italia.
dc.description.fil Fil: Pacianroni, Maurizio.University of Perugia. Stroke Unit and Division of Internal and Cardiovascular Medicine; Italia.
dc.description.fil Fil: Díez-Tejedor, Exuperio. La Paz University.Department of Neurology and Stroke Center; España. Hospital–Autonoma University of Madrid, IdiPAZ Health Research Institute; España.
dc.description.fil Fil: Fuentes, Blanca. La Paz University.Department of Neurology and Stroke Center; España. Hospital–Autonoma University of Madrid, IdiPAZ Health Research Institute; España.
dc.description.fil Fil: Rodríguez Pardo, Jorge.La Paz University.Department of Neurology and Stroke Center; España. Hospital–Autonoma University of Madrid, IdiPAZ Health Research Institute; España.
dc.description.fil Fil: Sánchez-Velazco, Sara. La Paz University.Department of Neurology and Stroke Center; España. Hospital–Autonoma University of Madrid, IdiPAZ Health Research Institute; España.
dc.description.fil Fil: Arauz-Gongora, Antonio. Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Stroke Clinic; Méjico.
dc.description.fil Fil: Ameriso, Sebastián Francisco.Fleni. Centro Integral de Neurología Vascular; Argentina.
dc.description.fil Fil: Pertierra, Lucía. Fleni. Departamento de Neurología; Argentina.
dc.description.fil Fil: Gómez-Schneider, Maia Macarena. Fleni. Departamento de Neurología; Argentina.
dc.description.fil Fil: Hawkes, Maximiliano Alberto.Fleni. Departamento de Neurología; Argentina.
dc.description.fil Fil: Barboza, Miguel A.University of Costa Rica. Hospital Dr.Rafael A. Calder´on Guardia. Neurosciences Department; Costa Rica.
dc.description.fil Fil: Chavarría Cano, Beatriz.Universidad Complutense de Madrid.Hospital General Universitario Gregorio Marañon. Vascular Neurology Section. Stroke Center. IiSGM Health Research Institute; España
dc.description.fil Fil: Iglesias Mohedano, Ana María.Universidad Complutense de Madrid.Hospital General Universitario Gregorio Marañon. Vascular Neurology Section. Stroke Center. IiSGM Health Research Institute; España.
dc.description.fil Fil: García Pastor, Andrés. Universidad Complutense de Madrid.Hospital General Universitario Gregorio Marañon. Vascular Neurology Section. Stroke Center. IiSGM Health Research Institute; España.
dc.description.fil Fil: Gil-Nuñez, Antonio. Universidad Complutense de Madrid.Hospital General Universitario Gregorio Marañon. Vascular Neurology Section. Stroke Center. IiSGM Health Research Institute; España.
dc.description.fil Fil: Putaala, Jukka.University of Helsinki. Helsinki University Central Hospital. Department of Neurology; Finlandia.
dc.description.fil Fil: Tatlisumak, Turgut.University of Helsinki. Helsinki University Central Hospital. Department of Neurology; Finlandia. University of Gothenburg; Sahlgrenska Academy . Institute of Neuroscience and Physiology Department of Clinical Neurosciences ; Suecia. Sahlgrenska University Hospital. Department of Neurology, Suecia.
dc.description.fil Fil: Karagkiozi, Efstathia.University of Thessaly. School of Medicine. Larissa University Hospital. Department of Medicine; Grecia.
dc.description.fil Fil: Papavasileiou, Vasileios.University of Leeds .NHS Trust and Medical School. Leeds Teaching Hospitals. Department of Neurosciences. Stroke Service; Reino Unido.
dc.description.fil Fil: Makaritsis, Konstantinos.University of Thessaly. School of Medicine. Larissa University Hospital. Department of Medicine; Grecia.
dc.description.fil Fil: Bandini, Fabio.San Paolo Hospital. Department of Neurology; Italia.
dc.description.fil Fil: Vemmos, Konstantinos. Alexandra Hospital.Medical School of Athens. Department of Clinical Therapeutics ; Grecia.
dc.description.fil Fil: Michel, Patrik. University of Lausanne; Suiza.Centre Hospitalier Universitaire Vaudois . Department of Clinical Neurosciences . Stroke Center and Neurology Service; Suiza.
dc.relation.ispartofVOLUME 93
dc.relation.ispartofPAGINATION 1-11
dc.relation.ispartofCOUNTRY Estados Unidos
dc.relation.ispartofCITY Hagerstown
dc.relation.ispartofTITLE Neurology
dc.relation.ispartofISSN 1526-632X
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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