Totaled health risks in vascular events score predicts clinical outcomes in patients with cardioembolic and other subtypes of ischemic stroke

Background and purpose: Whether totaled health risks in vascular events (THRIVE) score can be used to predict clinical outcomes and risk of hemorrhagic transformation in patients with special subtypes of ischemic stroke remains an open question.

Methods: We analyzed the possible relationships between THRIVE score and clinical outcomes in patients with cardioembolic stroke or noncardioembolic stroke who did not receive thrombolytic therapy. Clinical outcomes and hemorrhagic transformation within 3 months of admission were compared among 3 patient subgroups with initial THRIVE scores of 0 to 2, 3 to 5, or 6 to 9.

Results: A total of 505 patients with cardioembolic stroke and 3374 patients with noncardioembolic stroke were included in our analysis. As THRIVE score increased, the rate of patients showing good clinical outcome decreased, whereas the rate of mortality and hemorrhagic transformation increased after ischemic stroke. Increasing THRIVE score was independently associated with decreasing likelihood of good outcome, defined as a modified Rankin Scale score of 0 to 2 (cardioembolic stroke: odds ratio, 0.59; 95% confidence interval, 0.51-0.67; noncardioembolic stroke: odds ratio, 0.53; 95% confidence interval, 0.49-0.57), and with increasing likelihood of death (cardioembolic: odds ratio, 1.48; 95% confidence interval, 1.28-1.70; noncardioembolic: odds ratio, 1.95; 95% confidence interval, 1.76-2.16). THRIVE score showed good receiver operating characteristics for predicting good outcome and mortality in patients with cardioembolic stroke and noncardioembolic stroke.

Conclusions: The THRIVE score is a simple tool that helps clinicians estimate good outcome and death after ischemic stroke.