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2016 ; 16
(1
): 162
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Comparison of the Chinese ischemic stroke subclassification and Trial of Org
10172 in acute stroke treatment systems in minor stroke
#MMPMID27601009
Tan S
; Zhang L
; Chen X
; Wang Y
; Lin Y
; Cai W
; Shan Y
; Qiu W
; Hu X
; Lu Z
BMC Neurol
2016[Sep]; 16
(1
): 162
PMID27601009
show ga
BACKGROUND: The underlying causes of minor stroke are difficult to assess. Here,
we evaluate the reliability of the Chinese Ischemic Stroke Subclassification
(CISS) system in patients with minor stroke, and compare it to the Trial of Org
10172 in Acute Stroke Treatment (TOAST) system. METHODS: A total of 320 patients
with minor stroke were retrospectively registered and categorized into different
subgroups of the CISS and TOAST by two neurologists. Inter- and intra-rater
agreement with the two systems were assessed with kappa statistics. RESULTS: The
percentage of undetermined etiology (UE) cases in the CISS system was 77.3 % less
than that in the TOAST system, which was statistically significant (P?0.001).
The percentage of large artery atherosclerosis (LAA) in the CISS system was
79.7 % more than that in the TOAST system, which was also statistically
significant (P?0.001). The kappa values for inter-examiner agreement were 0.898
(P?=?0.031) and 0.732 (P?=?0.022) for the CISS and TOAST systems, respectively.
The intra-observer reliability indexes were moderate (0.569 for neurologist A,
and 0.487 for neurologist B). CONCLUSIONS: The CISS and TOAST systems are both
reliable in classifying patients with minor stroke. CISS classified more patients
into known etiologic categories without sacrificing reliability.