PROGNOSTICATION IN ACUTE CEREBROVASCULAR-DISEASE - SUBJECTIVE ASSESSMENT AND TEST OF A PROGNOSTIC SCORE

Abstract

Subjective assessment of the short-term outcome and functional state at discharge was made shortly after admission in 200 consecutive patients with acute cerebrovascular disease (CVD) treated in a stroke unit. The assessments proved correct in 59% of the patients. The accuracy of the predictions was not significantly better in patients with a correct preliminary diagnosis than in those with a false diagnosis. When a known prognostic score for prediction of hospital mortality was tested on 179 patients with cerebral hemorrhage or infarction, a correct trend was noted. The score was best applicable in patients with serious symptoms and those with only minor deficit on admission. A high sensitivity of the score was combined with a relatively low specificity. A true comparison between the predictive value of the score and the quality of the subjective assessments was difficult as the latter, in addition to prediction of mortality, also included prediction of the patient''s functional state at discharge. The degree of neurological deficit rather than the type of cerebrovascular lesion seemed associated with the short-term outcome. Improvement of the quality of prognostic assessments in CVD is warranted.