Objective: To study whether the totaled health risks in vascular events (THRIVE) score could predict the prognosis in the acute ischemic stroke patients with atrial fibrillation.
Methods: A total of 169 patients were enrolled in the study, with NIH Stroke Scale (NIHSS) score, THRIVE score and CHADS2 score given to each patients at admission and modified Rankin Scale (mRS) given at 3 months follow up. All patients were divided into the following 3 groups according to their THRIVE score: 1-3 score group, 4-5 score group and 6-9 score group.
Results: (1) There were 59 patients (34.9%) in the 1-3 score group, 71 patients (42.0%) in the 4-5 score group and 39 patients (23.1%) in the 6-9 score group. As the THRIVE score increased, significant difference was observed among the 3 groups in the mean age (F = 31.360, P = 0.000) and the level of fasting glucose (F = 12.410, P = 0.000). (2) As the THRIVE score increased in the 3 groups, the percentage of good prognosis in 3 months was significantly reduced (χ² = 48.259, P < 0.001), while the percentage of death and pulmonary infection were significantly increased (χ² = 36.754, P < 0.001; χ² = 16.590, P < 0.001, respectively). No significant difference was found in the percentage of intracerebral hemorrhage (ICH) among the 3 groups (χ² = 2.064, P = 0.356). (3) In the receiver operating characteristic (ROC) curve analysis, the THRIVE score was superior than the CHADS2 score in predicting poor prognosis (AUCROC = 0.797, P < 0.001 vs AUCROC = 0.579, P = 0.085) , death (AUCROC = 0.796, P < 0.001 vs AUCROC = 0.569, P = 0.198) and pulmonary infection (AUCROC = 0.708, P < 0.001 vs AUCROC = 0.573, P = 0.152). (4) Multifactor regression analysis suggested that the THRIVE score was an independent risk factor for good prognosis (OR = 0.406, P = 0.000) , death (OR = 2.083, P = 0.000) and pulmonary infection (OR = 2.168, P = 0.000).
Conclusions: In the acute ischemic stroke patients with atrial fibrillation, the THRIVE score negatively correlates with good prognosis, while positively correlates with death and pulmonary infection. The THRIVE score could strongly predict the clinical outcomes in those patients.