Bispectral index in predicting in-hospital mortality in patients with ischemic stroke: A methodological study
Background: Ischemic stroke is a leading cause of death and functional disability worldwide. Several clinical scores or stroke scales, biological test or markers, clinical signs, and radiological imaging have been performed to predict both worse neurologic outcome and mortality for ischemic stroke....
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| Veröffentlicht in: | Hong Kong journal of emergency medicine 2022-05, Vol.29 (3), p.144-150 |
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| creator | Akgol Gur, Sultan Tuna Akbas, Ilker Kose, Muhammed Zubeyir Kocak, Abdullah Osman Eren, Alper Cakir, Zeynep |
| description | Background: Ischemic stroke is a leading cause of death and functional disability worldwide. Several clinical scores or stroke scales, biological test or markers, clinical signs, and radiological imaging have been performed to predict both worse neurologic outcome and mortality for ischemic stroke.
Objectives: The aim of our study was to investigate the association between early Bispectral Index scores and in-hospital mortality in patients with ischemic stroke.
Methods: This is a comparative prospective methodological study, in which we evaluated the predictive accuracies of Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index for in-hospital mortality of patients with ischemic stroke. Receiver operating characteristic analysis was used for comparing the accuracy of the scoring systems, areas under receiver operating characteristic curves were calculated, and Youden J index was used for estimating associated cut-off values.
Results: Among the 80 ischemic stroke patients, in-hospital mortality rate was 38.8% (n = 31). The areas under receiver operating characteristic curves were 0.984, 0.960, and 0.863 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. The difference between areas under receiver operating characteristic curves for Bispectral Index and Glasgow Coma Scale was statistically similar. Besides, the difference between areas under receiver operating characteristic curves for Bispectral Index and Charlson Comorbidity Index, and the difference between areas under receiver operating characteristic curves for Glasgow Coma Scale and Charlson Comorbidity Index were statistically significant. The associated cut-off values were ⩽74, ⩽12, and >4 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. For these cut-off points, sensitivity and specificity of Bispectral Index were 93.6% and 95.9%, sensitivity and specificity of Glasgow Coma Scale were 100.0% and 83.7%, and sensitivity and specificity of Charlson Comorbidity Index were 83.9% and 69.4%, respectively. However, accuracy of Bispectral Index was 95.0%, accuracy of Glasgow Coma Scale was 90.0%, and accuracy of Charlson Comorbidity Index was 75.0.
Conclusion: Knowledge of the risk factors for mortality in patients with ischemic stroke can help to identify which patients have a higher risk of fatal outcome. The Bispectral Index score improved discrimination and classified patients with higher mortality better than both |
| doi_str_mv | 10.1177/1024907920908676 |
| format | Article |
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Objectives: The aim of our study was to investigate the association between early Bispectral Index scores and in-hospital mortality in patients with ischemic stroke.
Methods: This is a comparative prospective methodological study, in which we evaluated the predictive accuracies of Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index for in-hospital mortality of patients with ischemic stroke. Receiver operating characteristic analysis was used for comparing the accuracy of the scoring systems, areas under receiver operating characteristic curves were calculated, and Youden J index was used for estimating associated cut-off values.
Results: Among the 80 ischemic stroke patients, in-hospital mortality rate was 38.8% (n = 31). The areas under receiver operating characteristic curves were 0.984, 0.960, and 0.863 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. The difference between areas under receiver operating characteristic curves for Bispectral Index and Glasgow Coma Scale was statistically similar. Besides, the difference between areas under receiver operating characteristic curves for Bispectral Index and Charlson Comorbidity Index, and the difference between areas under receiver operating characteristic curves for Glasgow Coma Scale and Charlson Comorbidity Index were statistically significant. The associated cut-off values were ⩽74, ⩽12, and >4 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. For these cut-off points, sensitivity and specificity of Bispectral Index were 93.6% and 95.9%, sensitivity and specificity of Glasgow Coma Scale were 100.0% and 83.7%, and sensitivity and specificity of Charlson Comorbidity Index were 83.9% and 69.4%, respectively. However, accuracy of Bispectral Index was 95.0%, accuracy of Glasgow Coma Scale was 90.0%, and accuracy of Charlson Comorbidity Index was 75.0.
Conclusion: Knowledge of the risk factors for mortality in patients with ischemic stroke can help to identify which patients have a higher risk of fatal outcome. The Bispectral Index score improved discrimination and classified patients with higher mortality better than both Glasgow Coma Scale and Charlson Comorbidity Index.</description><identifier>ISSN: 1024-9079</identifier><identifier>EISSN: 2309-5407</identifier><identifier>DOI: 10.1177/1024907920908676</identifier><language>eng</language><publisher>Hong Kong: SAGE Publications</publisher><subject>Accuracy ; Bispectral Index ; Charlson Comorbidity Index ; Comorbidity ; Complications ; Diseases ; Glasgow Coma Scale ; Glasgow Coma Scale-Extended ; Hospital patients ; in‐hospital mortality ; ischemia ; Medical personnel and patient ; Mortality ; Nervous system ; Stroke ; Transient ischemic attack</subject><ispartof>Hong Kong journal of emergency medicine, 2022-05, Vol.29 (3), p.144-150</ispartof><rights>The Author(s) 2020</rights><rights>The Authors</rights><rights>The Author(s) 2020. This work is licensed under the Creative Commons Attribution – Non-Commercial License https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3897-2971f4ef638362fe2b6def3605ae24b67007abebe49b6e7dca37720fa207441f3</cites><orcidid>0000-0001-6676-6517 ; 0000-0002-1678-4474</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1177%2F1024907920908676$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1177%2F1024907920908676$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,860,11542,27903,27904,46031,46455</link.rule.ids></links><search><creatorcontrib>Akgol Gur, Sultan Tuna</creatorcontrib><creatorcontrib>Akbas, Ilker</creatorcontrib><creatorcontrib>Kose, Muhammed Zubeyir</creatorcontrib><creatorcontrib>Kocak, Abdullah Osman</creatorcontrib><creatorcontrib>Eren, Alper</creatorcontrib><creatorcontrib>Cakir, Zeynep</creatorcontrib><title>Bispectral index in predicting in-hospital mortality in patients with ischemic stroke: A methodological study</title><title>Hong Kong journal of emergency medicine</title><description>Background: Ischemic stroke is a leading cause of death and functional disability worldwide. Several clinical scores or stroke scales, biological test or markers, clinical signs, and radiological imaging have been performed to predict both worse neurologic outcome and mortality for ischemic stroke.
Objectives: The aim of our study was to investigate the association between early Bispectral Index scores and in-hospital mortality in patients with ischemic stroke.
Methods: This is a comparative prospective methodological study, in which we evaluated the predictive accuracies of Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index for in-hospital mortality of patients with ischemic stroke. Receiver operating characteristic analysis was used for comparing the accuracy of the scoring systems, areas under receiver operating characteristic curves were calculated, and Youden J index was used for estimating associated cut-off values.
Results: Among the 80 ischemic stroke patients, in-hospital mortality rate was 38.8% (n = 31). The areas under receiver operating characteristic curves were 0.984, 0.960, and 0.863 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. The difference between areas under receiver operating characteristic curves for Bispectral Index and Glasgow Coma Scale was statistically similar. Besides, the difference between areas under receiver operating characteristic curves for Bispectral Index and Charlson Comorbidity Index, and the difference between areas under receiver operating characteristic curves for Glasgow Coma Scale and Charlson Comorbidity Index were statistically significant. The associated cut-off values were ⩽74, ⩽12, and >4 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. For these cut-off points, sensitivity and specificity of Bispectral Index were 93.6% and 95.9%, sensitivity and specificity of Glasgow Coma Scale were 100.0% and 83.7%, and sensitivity and specificity of Charlson Comorbidity Index were 83.9% and 69.4%, respectively. However, accuracy of Bispectral Index was 95.0%, accuracy of Glasgow Coma Scale was 90.0%, and accuracy of Charlson Comorbidity Index was 75.0.
Conclusion: Knowledge of the risk factors for mortality in patients with ischemic stroke can help to identify which patients have a higher risk of fatal outcome. The Bispectral Index score improved discrimination and classified patients with higher mortality better than both Glasgow Coma Scale and Charlson Comorbidity Index.</description><subject>Accuracy</subject><subject>Bispectral Index</subject><subject>Charlson Comorbidity Index</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Diseases</subject><subject>Glasgow Coma Scale</subject><subject>Glasgow Coma Scale-Extended</subject><subject>Hospital patients</subject><subject>in‐hospital mortality</subject><subject>ischemia</subject><subject>Medical personnel and patient</subject><subject>Mortality</subject><subject>Nervous system</subject><subject>Stroke</subject><subject>Transient ischemic attack</subject><issn>1024-9079</issn><issn>2309-5407</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqFkc1P3DAQxaOqlVgBd46Rek7rj6wn7g1QgVKkXujZcpzxxtskTm2vYP97HFIJqYfWB4-s93tvRuOiuKDkE6UAnylhtSQgGZGkESDeFRvGiay2NYH3xWaRq0U_Kc5j3JPlANlKsinGKxdnNCnooXRTh8_5LueAnTPJTbv8qnofZ5eyPvqQi0vHV0Ynh1OK5ZNLfemi6XF0powp-F_4pbwsR0y97_zgd85kc0yH7nhWfLB6iHj-p54WP2--Pl7fVQ8_br9dXz5UhjcSKiaB2hqt4A0XzCJrRYeWC7LVyOpWQB5ft9hiLVuB0BnNARixmhGoa2r5afFxzZ2D_33AmNTeH8KUWyomgOVcEDxTZKVM8DEGtGoObtThqChRy17V33vNFrlantyAx__y6u77Pbu6IZQzyN5q9Ua9w7eB_tHrceXD6JIyfhjyPzk_xb1OUUXUwfTKTda_6j7sVOfdEsc5FW_CloOoG6ANkVSA5C8BIqZh</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Akgol Gur, Sultan Tuna</creator><creator>Akbas, Ilker</creator><creator>Kose, Muhammed Zubeyir</creator><creator>Kocak, Abdullah Osman</creator><creator>Eren, Alper</creator><creator>Cakir, Zeynep</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>24P</scope><scope>WIN</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><orcidid>https://orcid.org/0000-0001-6676-6517</orcidid><orcidid>https://orcid.org/0000-0002-1678-4474</orcidid></search><sort><creationdate>202205</creationdate><title>Bispectral index in predicting in-hospital mortality in patients with ischemic stroke: A methodological study</title><author>Akgol Gur, Sultan Tuna ; Akbas, Ilker ; Kose, Muhammed Zubeyir ; Kocak, Abdullah Osman ; Eren, Alper ; Cakir, Zeynep</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3897-2971f4ef638362fe2b6def3605ae24b67007abebe49b6e7dca37720fa207441f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Accuracy</topic><topic>Bispectral Index</topic><topic>Charlson Comorbidity Index</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Diseases</topic><topic>Glasgow Coma Scale</topic><topic>Glasgow Coma Scale-Extended</topic><topic>Hospital patients</topic><topic>in‐hospital mortality</topic><topic>ischemia</topic><topic>Medical personnel and patient</topic><topic>Mortality</topic><topic>Nervous system</topic><topic>Stroke</topic><topic>Transient ischemic attack</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akgol Gur, Sultan Tuna</creatorcontrib><creatorcontrib>Akbas, Ilker</creatorcontrib><creatorcontrib>Kose, Muhammed Zubeyir</creatorcontrib><creatorcontrib>Kocak, Abdullah Osman</creatorcontrib><creatorcontrib>Eren, Alper</creatorcontrib><creatorcontrib>Cakir, Zeynep</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Hong Kong journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akgol Gur, Sultan Tuna</au><au>Akbas, Ilker</au><au>Kose, Muhammed Zubeyir</au><au>Kocak, Abdullah Osman</au><au>Eren, Alper</au><au>Cakir, Zeynep</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bispectral index in predicting in-hospital mortality in patients with ischemic stroke: A methodological study</atitle><jtitle>Hong Kong journal of emergency medicine</jtitle><date>2022-05</date><risdate>2022</risdate><volume>29</volume><issue>3</issue><spage>144</spage><epage>150</epage><pages>144-150</pages><issn>1024-9079</issn><eissn>2309-5407</eissn><abstract>Background: Ischemic stroke is a leading cause of death and functional disability worldwide. Several clinical scores or stroke scales, biological test or markers, clinical signs, and radiological imaging have been performed to predict both worse neurologic outcome and mortality for ischemic stroke.
Objectives: The aim of our study was to investigate the association between early Bispectral Index scores and in-hospital mortality in patients with ischemic stroke.
Methods: This is a comparative prospective methodological study, in which we evaluated the predictive accuracies of Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index for in-hospital mortality of patients with ischemic stroke. Receiver operating characteristic analysis was used for comparing the accuracy of the scoring systems, areas under receiver operating characteristic curves were calculated, and Youden J index was used for estimating associated cut-off values.
Results: Among the 80 ischemic stroke patients, in-hospital mortality rate was 38.8% (n = 31). The areas under receiver operating characteristic curves were 0.984, 0.960, and 0.863 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. The difference between areas under receiver operating characteristic curves for Bispectral Index and Glasgow Coma Scale was statistically similar. Besides, the difference between areas under receiver operating characteristic curves for Bispectral Index and Charlson Comorbidity Index, and the difference between areas under receiver operating characteristic curves for Glasgow Coma Scale and Charlson Comorbidity Index were statistically significant. The associated cut-off values were ⩽74, ⩽12, and >4 for Bispectral Index, Glasgow Coma Scale, and Charlson Comorbidity Index, respectively. For these cut-off points, sensitivity and specificity of Bispectral Index were 93.6% and 95.9%, sensitivity and specificity of Glasgow Coma Scale were 100.0% and 83.7%, and sensitivity and specificity of Charlson Comorbidity Index were 83.9% and 69.4%, respectively. However, accuracy of Bispectral Index was 95.0%, accuracy of Glasgow Coma Scale was 90.0%, and accuracy of Charlson Comorbidity Index was 75.0.
Conclusion: Knowledge of the risk factors for mortality in patients with ischemic stroke can help to identify which patients have a higher risk of fatal outcome. The Bispectral Index score improved discrimination and classified patients with higher mortality better than both Glasgow Coma Scale and Charlson Comorbidity Index.</abstract><cop>Hong Kong</cop><pub>SAGE Publications</pub><doi>10.1177/1024907920908676</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-6676-6517</orcidid><orcidid>https://orcid.org/0000-0002-1678-4474</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Accuracy Bispectral Index Charlson Comorbidity Index Comorbidity Complications Diseases Glasgow Coma Scale Glasgow Coma Scale-Extended Hospital patients in‐hospital mortality ischemia Medical personnel and patient Mortality Nervous system Stroke Transient ischemic attack |
| title | Bispectral index in predicting in-hospital mortality in patients with ischemic stroke: A methodological study |
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