Background
Methods
Study design
Ethics
Study subjects
Diagnostic criteria
Inclusion criteria
Exclusion criteria
Data collection
Measurements
Outcome measurement
Predictors
Statistical analysis
Results
Participants
Baseline characteristics of the patients
Total | 3TCM Hospital | XW Hospital | |||||||
---|---|---|---|---|---|---|---|---|---|
Overall (n=489) | Good (n=278) | Poor (n=211) | Overall (n=413) | Good (n=232) | Poor (n=181) | Overall (n=76) | Good (n=46) | Poor (n=30) | |
Age,yearsa | 65.8 ±11.05 | 63.6 ± 10.95 | 68.6 ± 10.55 | 66.4 ± 10.80 | 64.0 ±10.89b | 69.6 ± 9.82 | 62.0 ± 11.68 | 61.8 ± 11.18 | 62.2 ± 12.60 |
Male, n (%) | 308 (63.0) | 185 (66.5) | 123 (58.3) | 254 (61.5) | 151 (65.1) | 103 (56.9) | 54 (71.1) | 34 (73.9) | 20 (66.7) |
Female, n (%) | 181 (37.0) | 93 (33.5) | 88 (41.7) | 159 (38.5) | 81 (34.9) | 78 (43.1) | 22 (28.9) | 12 (26.1) | 10 (33.3) |
Hypertension,n (%) | 304 (62.2) | 174 (62.6) | 130 (61.6) | 251 (60.8) | 143 (61.6) | 108 (59.7) | 53 (69.7) | 31 (67.4) | 22 (73.3) |
Stroke History, n (%) | 158 (32.3) | 79 (28.4) | 79 (37.4) | 135 (32.7) | 68 (29.3) | 67 (37.0) | 23 (30.3) | 11 (23.9) | 12 (40.0) |
CHD,n (%) | 115 (23.5) | 62 (22.3) | 53 (25.1) | 101 (24.5) | 51 (22.0) | 50 (27.6) | 14 (18.4) | 11 (23.9) | 3 (10.0) |
DM,n (%) | 99 (20.2) | 44 (15.8) | 55 (26.1) | 82 (19.9) | 37 (15.9)b | 45 (24.9) | 17 (22.4) | 7 (15.2) | 10 (33.3) |
AF,n (%) | 28 (5.7) | 15 (5.4) | 13 (6.2) | 24 (5.8) | 13 (5.6) | 11 (6.1) | 4 (5.3) | 2 (4.3) | 2 (6.7) |
Onset-admission, | |||||||||
hoursa | 10.3 ± 7.11 | 10.7 ± 7.23 | 9.7 ± 6.94 | 10.0 ± 7.17 | 10.2 ± 7.22 | 9.7 ± 7.12 | 11.6 ± 6.68 | 13.0 ± 6.90 | 9.38 ± 5.80 |
NIHSS, day 1a | 6.2 ± 4.77 | 4.4 ± 3.41 | 8.6 ± 5.24 | 6.3 ± 4.60 | 4.5 ± 3.17b | 8.5 ± 5.15 | 6.1 ± 5.67 | 3.9 ± 4.41 | 9.5 ± 5.76 |
BI,day90a | 77.9 ±24.26 | 94.4 ± 1.60 | 56.0 ± 22.84 | 77.7 ± 24.13 | 94.5 ± 1.55 | 56.4 ± 22.59 | 78.3 ± 25.12 | 94.2 ± 1.82 | 53.8 ± 24.59 |
The relationship between TCM symptoms and NIHSS score
TCM symptom & signs | Correlation coefficient (r2) | P value |
---|---|---|
Limb flaccid paralysis | 0.451 | 0.000 |
Incontinence of urinary | 0.325 | 0.000 |
Cough due to drinking | 0.308 | 0.000 |
Respiratory rude | 0.272 | 0.000 |
Irritability | 0.255 | 0.000 |
Anxiety | 0.249 | 0.000 |
Analeptic | 0.186 | 0.000 |
Stiffness and tension in the limbs | 0.132 | 0.003 |
Purple lips | 0.108 | 0.017 |
Salivation | 0.090 | 0.047 |
Tinnitus | −0.099 | 0.028 |
Thirst with desire to hot drink | −0.104 | 0.022 |
Frequent micturition | −0.107 | 0.018 |
Dry mouth | −0.117 | 0.009 |
Circumrotating | −0.141 | 0.002 |
Dizziness | −0.193 | 0.000 |
Construction of the new scale
Screening of the prognostic factors
Factors | Good (n = 232) | Poor (n = 181) | P value* |
---|---|---|---|
Spiritlessness, day 1,n (%) | 107 (46.1) | 105 (58.0) | 0.016 |
Anxiety day 1,n (%) | 49 (21.1) | 94 (51.9) | 0.000 |
Cough due to drinking, day 1,n (%) | 48 (20.7) | 69 (38.1) | 0.000 |
Anorexia,day 1,n (%) | 27 (11.6) | 39 (21.5) | 0.006 |
Salivation, day 1,n (%) | 22 (9.5) | 31 (17.1) | 0.021 |
Analeptic, day 1,n (%) | 17 (7.3) | 27 (14.9) | 0.013 |
Limb flaccid paralysis, day 1,n (%) | 11 (4.7) | 28 (15.5) | 0.000 |
Thirst with desire to hot drink, day 1,n (%) | 25 (10.8) | 9 (5.0) | 0.033 |
Circumrotating, day 1,n (%) | 25 (10.8) | 8 (4.4) | 0.018 |
Emaciation,n (%) | 9 (3.9) | 24 (13.3) | 0.000 |
Stiffness and tension in the limbs, day 1,n (%) | 12 (5.2) | 22 (12.2) | 0.010 |
Tinnitus, day 1,n (%) | 23 (9.9) | 5 (2.8) | 0.004 |
Irritability, day 1,n (%) | 5 (2.2) | 18 (9.9) | 0.001 |
Incontinence of urinary, day 1,n (%) | 10 (4.3) | 19 (10.5) | 0.015 |
Factors | Total (n =413) Change status | Good (n = 232) | Poor (n = 181) | P value |
---|---|---|---|---|
NIHSS | - | 0.54 ± 1.80 | −0.45 ± 2.74 | 0.000a |
TCM symptoms & signs | ||||
Irritability | appear,n (%) | 0 (0.0) | 3 (1.7) | 0.037 |
keep,n (%) | 230 (99. 1) | 166 (91.7) | ||
disappear,n (%) | 2 (0.9) | 12 (6.6) | ||
Circumrotating | appear,n (%) | 0 (0.0) | 4 (2.2) | 0.007 |
keep,n (%) | 220 (94.8) | 174 (96.1) | ||
disappear,n (%) | 12 (5.2) | 3 (1.7) | ||
Tinnitus | appear,n (%) | 1 (0.4) | 2 (1.1) | 0.002 |
keep,n (%) | 219 (94.4) | 179 (98.9) | ||
disappear,n (%) | 12 (5.2) | 0 (0.0) | ||
Difficult to cough sputum | appear,n (%) | 4 (1.7) | 7 (3.9) | 0.031 |
keep,n (%) | 221 (95.3) | 173 (95.6) | ||
disappear,n (%) | 7 (3.0) | 1 (0.6) |
Factor | Coefficient (S.E.) | OR (95 % CI) | P value |
---|---|---|---|
Age degree | 1.20 (0.34) | 3.32 (1.72–6.42) | 0.000 |
History of DM | 0.79 (0.32) | 2.20 (1.19–4.08) | 0.012 |
Anxiety, day 1 | 1.15 (0.26) | 3.17 (1.90–5.29) | 0.000 |
NIHSS score degree, day 1 | 1.12 (0.18) | 3.08 (2.16–4.40) | 0.000 |
Irritability, day 1 | 1.53 (0.62) | 4.61 (1.36–15.63) | 0.014 |
Change in NIHSS score during 3 days | 0.91 (0.33) | 2.49 (1.31–4.73) | 0.006 |
Change in circumrotating during 3 days | 2.05 (0.70) | 7.80 (1.98–30.64) | 0.003 |
Change in tinnitus during 3 days | 2.58 (1.10) | 13.25 (1.55–113.34) | 0.018 |
Adding weight value for each prognostic factors
Item | Weight | Assigned points |
---|---|---|
Age | 1 | 0 (≤56.44); 1 (>56.44) |
History of DM | 1 | 0 (no); 1 (yes) |
Anxiety, day 1 | 1 | 0 (no); 1 (yes) |
NIHSS score degree, day 1 | 1 | 0 (≤2),1 (3–6), 2 (>7) |
Irritability,day 1 | 1.5 | 0 (no); 1.5 (yes) |
Change in NIHSS score during 3 days | 1 | 0 (≤ − 1),1 (> − 1) |
Change in circumrotating during 3 days | 2 | 0 (disappear); 2 (keep); 4 (appear) |
Change in tinnitus during 3 days | 2.5 | 0 (disappear); 2.5 (keep); 5 (appear) |
Total score (sum of assigned points) | - | 0–16.5 |
Selection of cutoff value
Hospital | Good, n | Poor, n | Sensitivity (%) | Specificity (%) | Accuracy (%) |
---|---|---|---|---|---|
TG | FP | ||||
FG | TP | ||||
3TCM Hospitals | 159 | 73 | 68.5 | 83.4 | 75.1 |
30 | 151 | ||||
XW Hospital | 32 | 14 | 69.6 | 83.3 | 75.0 |
5 | 25 |
Validation of the scale for patients in Xuanwu hospital
Discussion
Summary of main findings
Item | Weight | Classify | Assigned point |
---|---|---|---|
Age degree | 1.0 | ||
≤56.44 | 0 | 0 | |
>56.44 | 1 | 1.0 | |
History of Diabetes | 1.0 | ||
No | 0 | 0 | |
Yes | 1 | 1.0 | |
Anxiety, day 1 | 1.0 | ||
No | 0 | 0 | |
Yes | 1 | 1.0 | |
NIHSS score, day 1 | 1.0 | ||
≤2 | 0 | 0 | |
2 < NIHSS score ≤ 6 | 1 | 1.0 | |
>6 | 2 | 2.0 | |
Irritability, day 1 | 1.5 | ||
No | 0 | 0 | |
Yes | 1 | 1.5 | |
NIHSS score change during 3 days | 1.0 | ||
≤ − 1 | 0 | 0 | |
> − 1 | 1 | 1.0 | |
Change in circumrotating during 3 days | 1.0 | ||
Disappear | 0 | 0 | |
Keep | 1 | 2.0 | |
Appear | 2 | 4.0 | |
Change in tinnitus during 3 days | 2.5 | ||
Disappear | 0 | 0 | |
Keep | 1 | 2.5 | |
Appear | 2 | 5.0 | |
Total score (sum of assigned points)a | 16.5 |