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External validation of a six simple variable model of stroke outcome and verification in hyper-acute stroke
  1. J M Reid1,
  2. G J Gubitz2,
  3. D Dai3,
  4. Y Reidy2,
  5. C Christian2,
  6. C Counsell4,
  7. M Dennis5,
  8. S J Phillips2
  1. 1
    Institute of Neurological Sciences, Glasgow, Scotland, UK
  2. 2
    Faculty of Medicine, Dalhousie University, Division of Neurology, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
  3. 3
    HealthCore, Inc., Wilmington, Delaware, USA
  4. 4
    Department of Medicine and Therapeutics, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, Scotland, UK
  5. 5
    Department of Clinical Neurosciences, Western General Hospital, Edinburgh, Scotland, UK
  1. Dr J M Reid, Institute of Neurological Sciences, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK; johnmreid{at}


We aimed to validate a previously described six simple variable (SSV) model that was developed from acute and sub-acute stroke patients in our population that included hyper-acute stroke patients. A Stroke Outcome Study enrolled patients from 2001 to 2002. Functional status was assessed at 6 months using the modified Rankin Scale (mRS). SSV model performance was tested in our cohort. 538 acute ischaemic (87%) and haemorrhagic stroke patients were enrolled, 51% of whom presented to hospital within 6 h of symptom recognition. At 6 months post-stroke, 42% of patients had a good outcome (mRS ⩽2). Stroke patients presenting within 6 h of symptom recognition were significantly older with higher stroke severity. In our Stroke Outcome Study dataset, the SSV model had an area under the curve of 0.792 for 6 month outcomes and performed well for hyper-acute or post-acute stroke, age < or ⩾75 years, haemorrhagic or ischaemic stroke, men or women, moderate and severe stroke, but poorly for mild stroke. This study confirms the external validity of the SSV model in our hospital stroke population. This model can therefore be utilised for stratification in acute and hyper-acute stroke trials.

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  • Dr Reid is supported by the Dalhousie University Internal Medicine Research Foundation and an unrestricted educational grant from Hoffmann-LaRoche and Merck Frosst.

  • Competing interests: None.

  • Abbreviations:
    area under the receiver operating characteristic curve
    modified Rankin score
    six simple variable