A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score.

De Marchis, Gian Marco; Dankowski, Theresa; König, Inke R; Fladt, Joachim; Fluri, Felix; Gensicke, Henrik; Foerch, Christian; Findling, Oliver; Kurmann, Rebekka; Fischer, Urs; Luft, Andreas; Buhl, Daniela; Engelter, Stefan T; Lyrer, Philippe A; Christ-Crain, Mirjam; Arnold, Marcel; Katan, Mira (2019). A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score. Neurology, 92(13), e1517-e1525. American Academy of Neurology 10.1212/WNL.0000000000007177

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OBJECTIVES To derive and externally validate a copeptin-based parsimonious score to predict unfavorable outcome 3 months after an acute ischemic stroke (AIS). METHODS The derivation cohort consisted of patients with AIS enrolled prospectively at the University Hospital Basel, Switzerland. The validation cohort was prospectively enrolled after the derivation cohort at the University Hospital of Bern and University Hospital Basel, Switzerland, as well as Frankfurt a.M., Germany. The score components were copeptin levels, age, NIH Stroke Scale, and recanalization therapy (CoRisk score). Copeptin levels were measured in plasma drawn within 24 hours of AIS and before any recanalization therapy. The primary outcome of disability and death at 3 months was defined as modified Rankin Scale score of 3 to 6. RESULTS Overall, 1,102 patients were included in the analysis; the derivation cohort contributed 319 patients, and the validation cohort contributed 783. An unfavorable outcome was observed among 436 patients (40%). For the 3-month prediction of disability and death, the CoRisk score was well calibrated in the validation cohort, for which the area under the receiver operating characteristic curve was 0.819 (95% confidence interval [CI] 0.787-0.849). The calibrated CoRisk score correctly classified 75% of patients (95% CI 72-78). The net reclassification index between the calibrated CoRisk scores with and without copeptin was 46% (95% CI 32-60). CONCLUSIONS The biomarker-based CoRisk score for the prediction of disability and death was externally validated, was well calibrated, and performed better than the same score without copeptin. CLINICALTRIALSGOV IDENTIFIER NCT00390962 (derivation cohort) and NCT00878813 (validation cohort).

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Kurmann, Rebekka; Fischer, Urs and Arnold, Marcel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1526-632X

Publisher:

American Academy of Neurology

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

14 Nov 2019 08:52

Last Modified:

14 Nov 2019 08:52

Publisher DOI:

10.1212/WNL.0000000000007177

PubMed ID:

30824558

BORIS DOI:

10.7892/boris.134776

URI:

https://boris.unibe.ch/id/eprint/134776

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