Acute physiology of stroke score.

BACKGROUND AND PURPOSE The Acute Physiology, Age, Chronic Health Evaluation score for critically ill patients has provided a method of predicting outcome using major physiological variables. We hypothesized that a physiology score for stroke patients (Acute Physiology of Stroke Score [APSS]) when added to a validated clinical prediction model would improve outcome prediction. METHODS The APSS was developed and validated using multivariable logistic regression. It was added to a previously validated clinical model to assess for increased area under the curve in predicting 3-month outcome. RESULTS The bootstrap-validated bias-corrected area under the curve for just the APSS predicting alive/dead at discharge was 0.753. The clinical model area under the curve ranged from 0.77 to 0.88 and the addition of the APSS resulted in areas under the curve of 0.77 to 0.89. CONCLUSIONS These data suggest that the APSS is related to 3-month clinical outcome in patients with ischemic stroke. However, the APSS adds no clinically relevant additional predictive value when added to our previously validated clinical prediction model.