Ischemic stroke subtype classification: a comparative study of ASCO, CISS and TOAST
10.3760/cma.j.issn.1673-4165.2013.06.004
- VernacularTitle:缺血性卒中的分型:ASCO、CISS和TOAST的比较研究
- Author:
Xiang LU
;
Wei HUANG
- Publication Type:Journal Article
- Keywords:
Stroke;
Brain Ischemia;
Risk Factors;
Reproducibility of Results
- From:
International Journal of Cerebrovascular Diseases
2013;21(6):430-434
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the differences in the clinical application of the etiological subtypes of ischemic stroke according to the TOAST,ASCO and CISS criteria.Methods A total of 167 consecutive patients with fist-ever ischemic stroke were enrolled in the study.They were classified with the TOAST,ASCO and CISS criteria,respectively.The differences and consistency of subtype diagnosis of each etiology were compared.Results Compared with TOAST,ASCO grade 1 significantly increased the proportion of patients in a large atherosclerosis group (23.4％ vs.19.8％ ;x2 =4.167,P =0.031) and decreased that in a small vessel disease group (32.9％ vs.38.3％ ; x2 =4.923,P =0.022); similarly,CISS also significantly increased the proportion of patients in the large atherosclerosis group (37.1％ vs.19.8％ ;x2 =27.034,P ＜0.001)and decreased that in the small vessel disease group (19.2％ vs.38.3％;x2=25.289,P ＜ 0.001).However,ASCO grade 1 (34.1％ vs.28.1％;x2 =3.682,P=0.052) and CISS (32.9％ vs.28.1％;x2 =0.880,P =0.268) did not decrease the proportion of patients in a cryptogenic group.The consistency of the 3 typing methods was between moderate (other etiology group of TOAST/ASCO-1,κ =0.434) and excellent (cardioembolism group of TOAST/ASCO-1,κ =0.967).Conclusions Both ASCO-1 or CISS typing may not decrease the proportion of the patients with the subtype of cryptogenic stroke,but the consistency among all the subtypes was better.The design and characteristics of the diagnostic criteria in all subtypes with the 3 criteria should be considered in clinical practice.
