hope什么意思缺血性脑中风英文文献及中文翻译

2021年1月26日发(作者：中法)
11
级药学
3
班

李浩然
201140705
神经科
学杂志



Ischemic Hemispheric Stroke





Predictive
value of the NIHSS for
ADL
outcome
after
ischemic hemispheric stroke:
Does
timing
of
early
assessment
matter?

缺血性脑 中风之后，关于日常生活
能力指数的国立卫生院卒中量表的预测价值
:
早期评估的时间 选择重要
吗？


Gert
Kwakkel
a
,
Janne M.
Veerbeek
a
,
Erwin E.H. van
Wegen
a
,
?
,
Rinske
Nijland
a
,
Barbara
C.
Harmeling-van
der Wel
b
,

Diederik
W.J. Dippel
c
,
the EPOS
investigators
作者

a
b
c

Research Institute
MOVE,
Department
of
Rehabilitation
Medicine,
VU
University
Medical Center, Amsterdam,
The
Netherlands
地址和职位

Department
of
Rehabilitation
Medicine and
Physical Therapy, Erasmus
MC
Rotterdam,
The
Netherlands

Department
of
Neurology, Erasmus
MC
Rotterdam,
The
Netherlands



a

r

t

i

c

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e

i

n

f

o

文
章信息

a

b

s

t

r

a

c

t



Background
and
purpose:
Early
prediction
of
future functional abilities
is
important
for
stroke management.
The
objective
of
the
present study
was to
investigate
the
predictive value
of
the
13-item National Institutes
of
Health Stroke
Scale (NIHSS),
measured within
72
h
after stroke,
for
the
outcome
in
terms
of
activities
of
daily
living (ADL)
6
months post stroke.
The
second
aim was to
examine
if the
timing
of
NIHSS
assessment
during
the
?
rst
days
post stroke affects
the
accuracy
of
predicting
ADL
outcome
6
months
post stroke.
Methods: Baseline characteristics
including
neurological
de?cits

were
measured
in
188
stroke patients, using
the
13-item
NIHSS,
within
72
h
and
at
5
and
9 days
after
a
?
rst-ever
ischemic hemispheric
stroke. Outcome
in
terms
of
ADL
dependency
was
measured with
the
Barthel Index
(BI) at 6
months
post
stroke.
The
area
under
the
curve
(AUC)
from
the
receiver operating characteristic
(ROC)
was
used
to
determine
the
discriminative properties
of the NIHSS at
days 2, 5
and
9
for
outcome
of the BI. In
addition,
at
optimal cut-off
odds ratio
(OR),
sensitivity, speci
?
city, positive
(PPV)
and negative predicted values
(NPV) for
the
different
moments
of
NIHSS
assessment
post stroke were
calculated.

Results: One
hundred and
?
fty-nine
of the 188
patients were assessed
at
a
mean
of 2.2
(1.3)
,
5.4
(1.4) and 9.0
(1.8)
days
after stroke. Signi
?
cant Spearman rank correlation
coef?cients
were found between
BI
at
6
months
and
NIHSS
scores
on
days
2
(r
s
=
0.549,
p b
0.001),
5
(r
s
=
0.592,
p b
0.001)
and
9
(r
s
=
0.567,
p b
0.001).
The AUC

ranged from 0.789
(95%CI,
0.715
–
0.864)
for
measurements
on
day
2
to 0.804
(95%CI,
0.733
–
0.874) and 0.808

(95%CI,
0.739
–
0.877)
for
days 5
and
9,
respectively.
Odds
ratio's ranged from 0.143
(95%CI,
0.069
–
0.295) for
assessment
on
day
2
to
a
maximum
of
0.148
(95%CI,
0.073
–
0.301)
for day
5. The
NPV
gradually increased from

0.610
(95%CI,
0.536
–
0.672)
for
assessment
on day 2
to
0.679
(95%CI,
0.578
–
0.765)
for day 9,
whereas
PPV
declined from 0.810
(95%CI,
0.747
–
0.875)
for
assessment
on
day
2
to 0.767
(95%CI,
0.712
–
0.814)
for day
9.
The
overall accuracy
of
predictions increased from
71.7% for
assessment
on
day 2
to
73.6% for
day
9.

Conclusions:
When measured within
9 days,
the
13-item
NIHSS
is
highly associated with
?
nal
outcome
in
terms
of
BI
at 6
months post stroke.
The
moment
of
assessment beyond
2 days
post stroke does
not
signi?cantly
affect
the
accuracy
of
prediction
of
ADL
dependency
at
6
months.
The
NIHSS can
therefore
be
used
at
acute hospital
stroke
units
for
early
rehabilitation
management
during
the
?
rst
9 days
post
stroke,
as the
accuracy of
prediction remained about
72%,
irrespective
of the
moment
of
assessment.

?
2010 Elsevier
B.V. All
rights reserved.


Article
history:
文章历史收录
了···期刊···

Received
10
February 2010

Received
in
revised form
7
April
2010

Accepted
7
April
2010

Available online
2
May
2010

Keywords:
Ischemic stroke
Prognosis

ADL
NIHSS



背景和目的：对未来功能能力的早期预知对中风的管理很重要目前研究目的是调查
13
项国立卫生院卒中量表的预测价值，方法是

测量中风后
6个月的日常生活活动对于中风后
72h
内症状的影响
.

第二个 目的是测试中风后几日卒中量表进行的评估是否影响中风
6
个月
之前预测日常生活活动 结果的精确性
.
方法：用
13
项
NIHSS
测量
188
位首次中风后
72h
内和
5
到
9
日后的基线 特征包括神经缺损特征
.
按照
ADL
的依赖条件下，测量结果与
Ba rthel
指数（
BI
）在中风后
6
个月进行测量
.
来自受试者特性

曲线下面的面积用来决定第
2
、
5
天的
NIHSS
和结果为
9
的
BI
区别性能。中风前不同时刻的
NIHSS
的最佳截止胜算比，

灵敏度，特异性阳性预测值和阴性预测值也被计算到了。

结果：
188位患者中的
159
位平均在中风后的
2.2(1.3),5.4(1.4). < br>9.0(1.8)
天被评估。重要的
spearman
范围相关系数在
6
个月的

BI
和在第
NIHSS
得分发现了分别在第
2(rs=0.549, p<0.001),5(rs=0.592, p<0.001)and9(rs=0.567, p<0.001)

天。曲线下面的面积的范围是从第
2
天的
0.7 89(95%CI,0.715
–
0.864)f
到第
5
天的
0.804(95%CI,0.733
–
0.874)
和第
9
天的 天的
73.6%
结论：经过
9
日的测量，
13
项
MIHSS
与中风后
6
个月的
BI
结果高度一致，中风后
2
天的评估没有明显影响到
6
个月日常生活活动依赖的精
确性。因此
N IHSS
可以用于

中风医院急性中风室对于中风之前
9
天的早期回复管理，鉴于

72%
的预测精确度，评估的时刻是无关的



1.
Introductio
n


The
incidence
of
stroke
is
increasing, with
an
estimated
600,000
new cases
in the
United States
every year
[1]
. In view
of the
long-term
disabilities
caused
by
stroke
[2]
the
need
for
an
accurate early
prediction
of
future
functional abilities
is
paramount
for
setting
therapeutic
goals,
starting
early
rehabilitation planning,
implementin
g

home adjustments
and
community support tailored
to
patients' needs,
and
informing patients
about their prospects
and
prognosis.
Several
stroke guidelines
recommend
that
rehabilitation
management
of
neurologically stable
stroke
victims should
start
as
early as
possible,
preferable
at
a
hospital stroke
unit
within
24
h post
stroke
[3,4]
.
< br>中风
的发生率在提高，美国每年大约发生
600000
例。鉴于脑卒中
会导致长期丧失能力为了制定治疗目标启动康复计划补充家
庭适应，和病人所需的社区支持，形成病人的 诊断和预期目
标，，早期精确的预测未来功能能力是非常重要的许多中风
知道方针建议中风患者 神经稳定性的复原管理应该尽量的
早。最好选择在医院的中风之前
24h
中风室。
NIHSS
经常作为内科医生和护士衡量中风患者神经受损严重
程度的标准工具 。
NIHSS
是中风专用量表来测定意识水平


语言功能、反应、眼球运动、面部对称性、运动强度、感
觉、协调性。

The
National Institutes
of
Health
Stroke
Scale (NIHSS) is
often used
as
a
standard measurement instrument
by
physicians
[5
–
9]
and
nurses
[10]
to
evaluate
the
severity
of a
patients'
neurological de
?
cit
in
emergency departments
and at
stroke units.
The
NIHSS
is a
stroke-
speci
?
c quantitative
scale
that
examines
the
level
of
consciousn
ess,
language
f
u
n
c
t
i
o
n
,
negle
ct
,
visual

?
elds,

eye
mo
ve
men
ts
,
f
acia
l
symmetry, motor strength, sensation,
and
coordination
[6]
.
The

examination
can be
performed
quickly,
and the
NIHSS score
can
be
assessed
by
neurologists
and
non- neurologists
after
appropriate
training
[6,7,11,12]
.
The
scale
shows excellent clinimetric properties
in
terms
of
reliability
and
validity
[7]
. The
NIHSS
has
been
used in
mo
st
acute
stroke
trials
evaluating
neurological
outcome
[6
–
9,
13,
14
]
.
Recently, the
A
me
r
ic
a
n

Heart Association
(A
HA
)

recommended
b
ed
s
i
de
NIHSS
assessment
as
a
valuable
tool
for
nursing
and
i
nt
e
r
di
sc
i
p
li
n
a
r
y
care of
the acute
ischemic
stroke
patient
[10]
.
The
NIHSS
s
h
o
w
s
sign
i?
cant association with
lesion
volume
[5,7,15]
as
well
as
with
?
na
l
outcome after
a
stroke
in
terms
of
survival
[5,16]
,
discharge
de
st
in
at
io
n
[16]
,
length
of
stay
(
L
O
S
)

[17]
,
activities
of daily
living
(
A
D
L
)

[9
,
11
,
18
–

22]
and
extended
ADLs
[23]
. For
e
x
a
mp
l
e
,
the
NINDS
trial
showed that a

lower baseline
NIHSS
score
during
the
?
rst
24
h
post
stroke
wa
s
independently
associated
with
a
favorable
outcome
in
terms
of
t
h
e
Barthel
Index (BI) and
the modi
?
ed
Rankin Scale
(mRS) measured
o
n
e
year
post
stroke
[9]
. H
o
we
v
e
r
,
clinical
observations suggest that
the
?
rs
t

48
h
after
an
ischemic
stroke
is
associated with
potential
i
ns
t
ab
ili
ty
,
which
may
lead to
secondary
deterioration
in
the
?
rst
days due
to
a
series
of
biochemical
reactions
in the
brain
often
r
e
f
e
rr
ed

to
as
a
n

‘
ischemic cascade
’

[24]
.
F
ur
the
r
m
o
r
e
,
a
longitudinal study
i
nv
e
s
t< br>ig
a
t
i
ng


changes
in
impairments
in a
repeated measurement design showed
th
at
progress
of
time
is an
independent
covariate related to improvements
o
f
body
functions
and
activities
in
the
?
rst weeks post
str
ok
e
,
r
e
?
ec
t
i
n
g
spontaneous
neurological recovery
[25]
.

这项测试执行的很快，
NIHSS
量表可以是 精神专家也可以是非精神专
家经过培训之后进行评估。这项量表在可靠性和稳定性方面显示了杰出
的性能
.

NIHSS
应用于大多数的急性中风神经结果的审判。最近，美 国心
脏协会（
AHA
）建议床边的
NIHSS
评估急性缺血性中风的 病人护理，作
为护理和跨学科的宝贵工具。
NIHSS
和中风后幸存的最终结果生存时
间、损害程度、解除终老、、日常生活活动、和延长生活活动有显著关
联性
.

。例如：
NINDS
实验显示了中风之前
24h
内
NIHS S
基线分值低的独
立于一个满意的
BI
和中风前一年测量的
mRS< br>结果。但是，临床观察者提
出中风后
48h
是和因潜在基础薄弱，大脑生化华反 应导致最初几天二次恶
化的称为“缺血连锁反应”有关。反复测量和设计的纵向调研的损害的
改 变显示了时间进展独立于中风最初几周的身体功能和活动，反应了神
经系统无意间可以恢复
..
Despite
the
recommendations
of
the
AHA
stroke
guidelines
for
using
the
NIHSS
[10]
, the
optimal moment
for
predicting
ADL
outcome
for
the
purpose
of
rehabilitation management
at
stroke units remains
unclear.
In
addition,
it is
unclear
to
what extent
the
moment
of NIHSS
measurement
(in
terms
of days post
stroke) determines
the
accuracy
with which
?
nal
ADL
outcome
at
6
months
after
stroke
is
predicted.

尽管美国心脏学会提出了
NIHSS
中风知 道方针的建议，但是中风康复
的最佳预测
ADL
的时间扔不清晰。而且
NIH SS
中风后测评的时刻对于中
风后
6
个月
ADL
精确结果的 决定程度也被预测。

The
?
rst
objective
of the
present study
was
therefore
to
investigat
e
the
predictive
value of NIHSS
measured
within
72 h for the ADL
outcome
assessed
at 6
months
post
stroke.
The
second
aim
was
to
determine
if
re-assessment
of
NIHSS
on
days
5 and
9 post
stroke
affects the
accuracy
of
predicting
ADL
outcome assessed
at
6
months
post
stroke.

目前研究的首要目的是调查
NIHS S
的预测价值，预测
中风后
6
个月
72h
的
ADL
结果。第
2
个目的是判定在中风后
5
天和
9
天重复 使用
NIHSS
是否影响中风后
6
个月
ADL
结果的精确性











58

G.
Kwakkel
et al.
/
Journal
of
the
Neurological
Sciences
294
(2010)
57
–
61



2.
Subjects
and methods


2.1.
Design


The
EPOS
study
(Early
Prediction
of
functional Outcome after
S
t
r
o
ke
)
is a
prospective cohort
s
t
ud
y

that implements
early,
intensively
r
epe
at
ed
measurements starting within
72 h
after stroke onset.
The
diagnosis
o
f
stroke
was
based
on
the de
?
nition
by
the World Health
Org
aniza
ti
o
n
[26]
.
Over
a
period
of
24
m
o
nt
hs
,
188
patients were recruited
from
9
hospital stroke units
in
the
Netherlands (viz.
E
r
as
mu
s
MC
R
o
tt
e
r
d
a
m
;
UMC
Utrecht;
VU
medisch centrum
A
ms
t
e
r
d
a
m
;

AMC
A
m
st
e
r
d
a
m
;
UMC
S
t
. R
a
d
b
o
ud
Nijmegen;
LUMC
L
e
i
de
n;
A
mp
h
i
a
Hospital
Breda;
F
r
a
n
ci
s
-
cus
Hospital
R
oo
se
nd
aa
l
and
Diakonessen
Hospital
L
e
i
de
n)
.
The
EPOS
test battery
was
applied
within
72 h
after stroke
and
re-assessed
on
d
ays

5 and
9,
while
?
nal
ADL
outcome
was
assessed at
6
months after
s
t
r
ok
e
onset.
All
measurements
were
performed
by
24
trained
p
h
y
sica
l
therapists
working
at
the
stroke
unit
of
each
participating
c
e
n
t
e
r
.
Patients recruited
for
the
EPOS
study received
usual
rehabilitation
c
a
r
e
according to the Dutch
Clinical
Practice Guidelines
for Physical
T
he
r
a
p
y
[27]
. The EPOS
research
protocol
was
approved
by
the
local
e
t
hi
ca
l
review
boards
of
the
participating ho
s
p
i
t
a
l
s.

EPO S
（早期预测中风
后功能的结果）是一项预期研究早期应用的工具，集中重复测
量于中 风后
72h
内着手开展。中风的诊断是基于
WHO
的定义
24
个月的时间，来自
9
个荷兰医院（
9
个医院名字）中风室的
188
位病人被征集起来。
EPOS
成套测验在中风后
72h
内和第
5
天第
9
天再评估时被应用，但最终的
ADL
结果在中风后
6
个月评估，
所有测量值由
24
位被培训过的体格治疗专家在各参加中心的 中
风室形成，被征集的病人依据荷兰临床实践指南得到

常规康复治疗。
EP OS
调查草案被当地参加的医院的伦理调查
委员会批准。





2.2.
Subjects


Participants
of
the
EPOS
study
had
to
meet
the
following
inclusion
criteria:
[1]
diagnosed with
a
?
rst-ever ischemic stroke
in
one of
the
hemispheres;
[2]
type
and
localization
of
stroke were determined
by
a
neurologist, intracranial hemorrhage
was
ruled
out
by
CT
or MRI
scan;
[3]
incurred
a
monoparesis
or
hemiparesis
within
the

?
rst

72
h
afterstroke;
[4]
no
pre-morbid
disability
in
terms
of the
Barthel
Index
(pre-
morbid
BI
≥

19);
[5]
age
18
years

or
older
and

[6]
able
to
understand
instructions
and

to

provide
verbal
or

written
informed consent
to participate
.
< br>参加
EPOS
研究的人员已经达成了以
下结论条件：
1
）诊断 为首大脑半球缺血性中风

2
）中风的类型和定位是经过神经科一是诊断的并经过CT
和
MRI
排除颅
内出血
3
）中风后
72h
内遭受单瘫或偏瘫

4
）依照巴氏量表没有前病态残疾

5
）
18
岁或以上

6
）能够理解指令，并提供口头的或数卖弄的知情同意来参与



2.3.
Dependent variable


The level
of
ADL
independency
6
months
after
stroke
was
assessed
by the score on
the
Barthel
Index (BI). This
hierarchical
scale
assesses
everyday
tasks
and

covers

functional
items:
fe
ed
in
g
,
t
r
an
sfe
r
,
grooming
,

toilet
use,
bathing,
mobility,
stairs,
dressing,
and
bowel
and
bladder
control
[28]
. The
maximum
score
is
20
points. Patients
with
scores
≥
19
were
classi?ed

as
independent
for
basic ADL,
whereas patients with
scores
≤
18
were
classi?ed

as
ADL- depe
ndent
[29
中风后
6
个月的独立
ADL< br>水平被用
BI
记分评估。这种分
层记分评估了日常任务，
]

涵盖功能性项目
.

喂养，转让，疏
导，卫生间使用，洗澡，流动性，楼梯，

穿衣和大小便控 制。最高分
是
20
分，不小于
19
分的病人被归类到基本
A DL
自理的一类，而不大于
18
分的被归到
ADL
依赖的一类


2.4.
Independent
variables


Baseline characteristics were
assessed
by
trained assessors
within

72
h after
stroke
and
included:
(1) age;
(2)
gender;
(3) type of
stroke
(according to
the
Bamford
Oxford
Community
Stroke
Project
[OCSP]
classi?cation)

[30]
; (4)
number
of
days
elapsed between stroke and
?
rst
assessment;
(5) left
or
right hemispheric stroke according
to
CT
or
MRI scan;
(7)
urinary incontinence,
as
assessed with
the
bladder
item
of the
BI; (8)
severity
of
upper
and
lower
limb
paresis
as
assessed
with
the
Motricity
Index
(MI)
and
Fugl
–
Meyer motor
score
(FM);
(10)
co-morbidity
as
measured with
the
Cumulative
Illness Rating
Scale
at
baseline
(CIRS)
[31]
;
(11)
modi?ed

Rankin Scale
(mRS);
(12) Barthel
Index (BI) and
the
13-item version
of the
National Institutes
of
Health
Stroke
Scale
(NIHSS)
[7,12]
measured
within
72
h,
on days 5
and
9
post
stroke.
The NIHSS
score
ranges
from
0
to
42
points,
with
0
indicating
normal
neurological function
and
42
indicating
no
func-
tions
[5,7,12]
. Finally,
the
outcome
of BI and mRS was also
used as
a
descriptive outcome
at
6
months
post
stroke.

基线特征被培训过的
评估者用于评估 中风后
72h
包括：（
1
）年龄
;
（
2
） 性别

（
3
）中风类型（按班福德牛津社区卒中项目
[OCSP分
]
（
4
）中风和经过首次评估之间的天数，

（
5
）左还是右大脑半球中风根据
CT
或
MIR
（
7
）尿失禁，用
BI
评估膀胱项目
;
（
8
）严重程度上，下肢麻痹用
MI
或
FM
评估

10
）复合发病率用
CIRS
评估

（
11
）改良
Rankin
量表（
MRS
）

（
12
）
BI
指数和
13
项
NIHSS
在中风前
5
天和
9
天的
72h
内测定
NI HSS
评分的范围从
0
到
42
分，
0
分代表正常的 神经功能和
42
表
示

没有功能的。最后，
BI
的结果以及
mRS
也被

用来作为在中风后
6
个月描述的结果。






















2.5.
Procedure

G.
Kwakkel
et al.
/
Journal
of
the
Neurological
Sciences
294
(2010)
57
–
61

59


The
research protocol started within
72
h
after
stroke onset, and
follow-up assessments
took place after 5
and 9 days in
each
hospital
stroke
unit. The
?
nal
measurement, scheduled
at
6
months post
stroke,
was
performed
at the
location
of
discharge
(i.e.,
home, nursing
home
or
rehabilitation
center)
or
at
the
outpatient
clinic
of
the
hospital
.
All
assessors
in each
stroke
unit
were experienced therapis
ts,
and
were additionally trained
to
apply the
EPOS
test
battery
in a
one-
day (8 h)
course.
In
addition,
all
assessors
had to
pass the
exam on
using the NIHSS
recommended
by
the
American Heart
Association's
Professional
Education
Center
[7,12]
.

该研究方案开始于中风发作后72
小
时内后续的评估发生在各医院中风室的第
5
天和第
9天最后的测量在中风后的

6
个月在地方卸货点进行（即，家庭，护理在家中或

康复中心），或在门诊诊所。素有的评估者都是老练治疗者，都经过了

一天关于应用
EPOS
的培训，而且所有评估者必须通过美国心脏学会专业心
推荐的
NIHSS
考试


2.6.
Data
analyses


The
possible
association
between
the
moment
of
NIHSS
measure
-
ment (a
f
t
e
r
72 h and 5 and 9
days)
and
the
BI
assessment
at
6
m
o
n
t
h
s
was
examined
by
calculating
S
pe
a
r
m
a
n
rank
correlation
c
o
e
f
?
ci
en
t
s
.

O
n
the
basis
of
sensitivity/1-speci
?
city
and
maximum
area
(A
UC
)

under
th
e
receiver
operating
characteristic
(ROC)
curve,

the

discriminative
properties
and
optimal
dichotomization
of
NIHSS
were estimated
f
o
r
each
assessment
day
to predict dichotomized
(i.e.,
≥
19
points)
o
u
t
c
o
me
of
BI at 6
m
o
n
t
h
s
.

Su
bs
eque
nt
ly
,

bivariate
logistic
regression
an
alysis
was
performed between
ADL
independency
on
the
BI
(i.e.,
≥
19
po
i
n
t
s
)
at 6
m
o
n
t
h
s
,
and
the
NIHSS
score
measured within
72 h, and
odds
r
a
t
i
os
(OR) with
their
95
%

con
?
dence intervals
(9
5%C
I
s
)

were estimated.
Th
e
same analyses were repeated
for
the data collected
5
and 9 days
p
os
t
st
ro
ke
.
The
ROC
curves
of
both models were graphically displayed a
n
d
tested
if the
AUC
measured
at days
2, 5 and
9
differed sign
i?
cantly fr
om
each
o
t
h
e
r
.
AUCs
were
signi
?
cantly different
if
z
≥
1.96. The
paired
z
scores
for
the estimated
AUC
for
the three different
days
were
ca
lc
ul
at
ed

by using
the equation:
z
=
A
U
C
1

?

AU
C
2

/

√
(S
E
1

+S
E
2

?

2r
SE
1
SE
2
),

wi
t
h

r as
the Pearson product moment correlation coe
f?
cient between bo
t
h
days
[32]
. Finally,
2-way
contingency
tables
were
used
to
c
a
lc
u
la
t
e
sensitivity,
sp
ec
i
?
ci
ty
,
and
negative
(NPV)
and
positive
pr
ed
ic
t
iv
e
values
(PPV),
including their
95
%
C
I
s
,
for
each
model within
72 h
po
st
stroke
and on
days 5
and 9
post
st
ro
ke
.
All
analyses were
tw
o
-
t
a
il
ed
,
using a
critical p-value
for
signi
?
cance
of 0.05.
All
analyses were d
o
n
e
with
SPSS
version 15
.


NIHSS
评估的时间和
6
个月的
BI
指数评估之间的可能相关性被
spea rman
等级相关系数进行了检测。基于敏感度和专业性，来自
于操作者性能的曲线下最大面积 、
MIHSS
区分程度被每日测评
来预测
6
个月的
BI指标二分结果。随后，符号逻辑和变量回归分
析在
72h
内
ADL
独立性和
95%
可靠性的又算比之间进行评估。
z
≥
>1.96
时
AUC
显著不同。三个不同时间的
AUC
得分被用方程式
z
=AUC1 ? AUC2 /
√
(SE1 +SE2 ? 2rSE1SE2)

计算出，其中
r
代表
两天之间的皮尔森积差系 数，最终，
2
路应变表被用于计算敏感
性，特异性和阴性和阳性预测值，包括其
95
％的
Cls
每个模型在
中风后
72
小时，
5
天、
9
天。所有的分析都是双尾的，用重要的
P
为
0.05
的值，所有的分析都是在
15
版本的
SPSS
完成的