Recurrence Prediction of Essen Stroke Risk and Stroke Prognostic Instrument-II Scores in Ischemic Stroke: A Study of 5-Year Follow-Up

Objective: To evaluate the predictive accuracy of the Essen Stroke Risk Score and the Stroke Prognostic Instru-ment II score on the long-term recurrence in Chinese patients with acute ischemic stroke.Methods: Patients with acute ischemic stroke were enrolled and had completed ESRS and SPI-II scores. Patients were stratified according to the Essen Stroke Risk Score and Stroke Prognostic Instrument II score and were followed until stroke recurrence or composite endpoint event (stroke recurrence, myocardial infarction or car-diovascular death). We estimated stratified incidence rates and calculated the cumulative risks at 5 years using Kaplan-Meier estimates. We used receiver operating characteristic (ROC) curves to compare the predictive ability of the Essen Stroke Risk Score and Stroke Prognostic Instrument II score.Results: A total of 578 patients completed the follow-up. The cumulative 5-year event rates were 32.3% (95% CI, 28.2% to 36.4%) for recurrent stroke and 37.9% (95% CI: 33.8%-42.0%) for composite endpoint event. The cumulative risk of all outcomes increased with increasing risk scores. AUC for ESRS and SPI-II risk scores were 0.613 (95% CI: 0.565-0.661) and 0.613 (95% CI: 0.564-0.662) for 5-year stroke recurrence respectively and correspondingly 0.622 (95% CI: 0.576-0.668) and 0.627 (95% CI: 0.581-0.674) for composite endpoint events.Conclusion: In Chinese patients with acute ischemic stroke, both Essen Stroke Risk Score and Stroke Prognostic Instrument II scores could equally stratify the risk of 5-year recurrent stroke and combined vascular events.