• Title/Summary/Keyword: Stroke prediction

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Discriminant Model V for Syndrome Differentiation Diagnosis based on Sex in Stroke Patients (성별을 고려한 중풍 변증진단 판별모형개발(V))

  • Kang, Byoung-Kab;Lee, Jung-Sup;Ko, Mi-Mi;Kwon, Se-Hyug;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.1
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    • pp.138-143
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    • 2011
  • In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. As a part of researches for standardization and objectification of differentiation of syndromes for stroke, in this present study, we tried to develop the statistical diagnostic tool discriminating the 4 subtypes of syndrome differentiation using the essential indices considering the sex. Discriminant analysis was carried out using clinical data collected from 1,448 stroke patients who was identically diagnosed for the syndrome differentiation subtypes diagnosed by two clinical experts with more than 3 year experiences. Empirical discriminant model(V) for different sex was constructed using 61 significant symptoms and sign indices selected by stepwise selection. We comparison. We make comparison a between discriminant model(V) and discriminant model(IV) using 33 significant symptoms and sign indices selected by stepwise selection. Development of statistical diagnostic tool discriminating 4 subtypes by sex : The discriminant model with the 24 significant indices in women and the 19 significant indices in men was developed for discriminating the 4 subtypes of syndrome differentiation including phlegm-dampness, qi-deficiency, yin-deficiency and fire-heat. Diagnostic accuracy and prediction rate of syndrome differentiation by sex : The overall diagnostic accuracy and prediction rate of 4 syndrome differentiation subtypes using 24 symptom and sign indices was 74.63%(403/540) and 68.46%(89/130) in women, 19 symptom and sign indices was 72.05%(446/619) and 70.44%(112/159) in men. These results are almost same as those of that the overall diagnostic accuracy(73.68%) and prediction rate(70.59%) are analyzed by the discriminant model(IV) using 33 symptom and sign indices selected by stepwise selection. Considering sex, the statistical discriminant model(V) with significant 24 symptom and sign indices in women and 19 symptom and sign indices in men, instead of 33 indices would be used in the field of oriental medicine contributing to the objectification of syndrome differentiation with parsimony rule.

A study on the development of severity-adjusted mortality prediction model for discharged patient with acute stroke using machine learning (머신러닝을 이용한 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발에 관한 연구)

  • Baek, Seol-Kyung;Park, Jong-Ho;Kang, Sung-Hong;Park, Hye-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.126-136
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    • 2018
  • The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

The Case-control Study of Ischemic Stroke according to Sasang Constitution (사상체질에 따른 허혈성 뇌졸중 환자-대조군 연구)

  • Hwang Min-Woo;Lee Tae-Gyu;Lee Soo-Kyung;Song Il-Byung;Choe Bong-Geun;Koh Byung-Hee
    • The Journal of Korean Medicine
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    • v.27 no.1 s.65
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    • pp.118-129
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    • 2006
  • Objectives : A human being is classified into 4 constitutions(Taeyangin, Soyangin, Taeumin, and Souemin) and each constitution has the different incidence, treatment and prevention of disease in Sasang Constutional Medicine[SCM], The purpose of this study is to find relative risk(RR)s of each risk factors including Sasang Constitution[SC] for incidence of ischemic stroke. Methods : In 344-case patients with ischemic stroke and 1446 healthy control subjects without ischemic stroke, we evaluated sex, age. height, weight, BMI, ECG abnormality, hypertension, diabetes mellitus, blood lipid level and SC. These data were statistically analysed to investigate the relations between risk factors and the incidence of ischemic stroke by chi-square test. And then significant factors were analysed to get each adjusted odds ratio[OR] by binary logistic regression analysis. Results : ECG abnormality, hypertension, diabetes mellitus, HDL(high density lipoprotein) cholesterol, and SC were significantly related to the incidence of ischemic stroke, while age, sex and BMI were adjusted in a binary logistic regression analysis. Especially in SC, the incidence of ischemic stoke in Tae-eumin and Soyangin were higher than that in Soeumin (Tae-eumin OR=11.68[95% CI: 6.26-21.80], Soyangin OR=4.64[95% CI: 2.66-8.10]). Conclusions : These results suggested that SC may be one of important risk factors for ischemic stroke and it should be a useful data for prediction of incidence of ischemic stroke.

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Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque

  • Zhe Huang;Xue-Qing Cheng;Ya-Ni Liu;Xiao-Jun Bi;You-Bin Deng
    • Korean Journal of Radiology
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    • v.24 no.4
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    • pp.338-348
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    • 2023
  • Objective: Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine whether plaque enhancement can contribute to risk assessment for recurrent stroke compared with the Essen Stroke Risk Score (ESRS). Materials and Methods: This prospective study screened 151 patients with recent ischemic stroke and carotid atherosclerotic plaques at our hospital between August 2020 and December 2020. A total of 149 eligible patients underwent carotid CEUS, and 130 patients who were followed up for 15-27 months or until stroke recurrence were analyzed. Plaque enhancement on CEUS was investigated as a possible risk factor for stroke recurrence and as a possible adjunct to ESRS. Results: During follow-up, 25 patients (19.2%) experienced recurrent stroke. Patients with plaque enhancement on CEUS had an increased risk of stroke recurrence events (22/73, 30.1%) compared to those without plaque enhancement (3/57, 5.3%), with an adjusted hazard ratio (HR) of 38.264 (95% confidence interval [CI]:14.975-97.767; P < 0.001) according to a multivariable Cox proportional hazards model analysis, indicating that the presence of carotid plaque enhancement was a significant independent predictor of recurrent stroke. When plaque enhancement was added to the ESRS, the HR for stroke recurrence in the high-risk group compared to that in the low-risk group (2.188; 95% CI, 0.025-3.388) was greater than that of the ESRS alone (1.706; 95% CI, 0.810-9.014). A net of 32.0% of the recurrence group was reclassified upward appropriately by the addition of plaque enhancement to the ESRS. Conclusion: Carotid plaque enhancement was a significant and independent predictor of stroke recurrence in patients with ischemic stroke. Furthermore, the addition of plaque enhancement improved the risk stratification capability of the ESRS.

Clinical Usefulness on K-MBI for Decision of Driving Rehabilitation Period in Patients with Stroke: A pilot study (뇌졸중 환자의 운전재활 시기 결정을 위한 K-MBI의 임상적 유용성: 예비 연구)

  • Park, Myoung-Ok
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.11 no.2
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    • pp.91-98
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    • 2017
  • Background & Object: Basic daily activity screening tool such as the Modified Barthel Index (MBI) has been used commonly in rehabilitation clinic and community based rehabilitation setting. Previous studies have shown the significant relations between the level of daily activities and driving ability on stroke or elderly people. However, there is a lack of studies to investigate the usefulness of MBI on prediction of driving ability for stroke patient. This study was to predict driving abilities of stroke survivor using Korean version Modified Barthel Index (K-MBI). Methods: A sample of 48 patients with stroke in rehabilitation hospital was recruited. All participants were tested level of basic daily activities using K-MBI. The driving ability of participants was tested using virtual reality driving simulator. The predictive validity was calculated of the K-MBI among pass or fail group of driving simulator test using receiver operating characteristics curves. Results: The cut-off score of >86.5 on the K-MBI is proper sensitivity to predict on driving performance ability. Conclusion: This pilot result offers clinical reference to therapists and caregivers for reasoning on driving recommendation period during rehabilitation stage of stroke survivors. Further studies need to identify prediction using real on-road test in a large population group.

A prediction of the scavenging efficiency and the performance of a two-stoke SI engine with the different exhaust systems (배기관 형상에 따른 2행정기관의 소기효율 및 성능 예측)

  • Chung, J.E.
    • Transactions of the Korean Society of Automotive Engineers
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    • v.3 no.2
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    • pp.130-135
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    • 1995
  • In this paper, the numerical simulation of the method of characteristics for a two-stroke SI engine was carried out, and the scavenging efficiency and the performance of single engine with two types of exhaust system, that is, a pipe exhaust system and a tuned exhaust system, were predicted and compared. The conculusions are obtained as follows. (1) The method of characteristics of hometropic flow considering the friction and the variation of area is useful to predict the scavenging efficiency and the performance of the two-stroke engine. (2) The shape of exhaust system effects directly on the scavenging and the trapping efficiency. (3) A tuned exhaust system consisted of the diffuser and the convergent nozzle makes the plugging pulse and therefore enhances the scavenging and the trapping efficiency. (4) It may be possible to design the optimum exhaust system by using the plugging pulse.

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압축 착화 기관의 연소 변동 특성에 관한 연구

  • 이창식
    • Journal of the korean Society of Automotive Engineers
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    • v.9 no.1
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    • pp.69-76
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    • 1987
  • This paper deals with the theoretical prediction and cyclic variation of combustion characteristics in a four stroke, single0cylinder, diesel engine. Theoretical calculations employed a simple empirical model of analysis of energy equation for the thermodynamic system of engine cylinder. The cyclic variation of combustion characteristics is investigated, in term of frequency distribution and standard deviation of peak characteristics, as obtained by combustion analyzer system. The results of theoretical prediction are shown to be in close agreement with the experimental data. The effect of fuel injection timing, engine speed, cooling water temperature, and the compression ratio on the cyclic variations of combustion characteristics were discussed.

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Predictive validity of the gait scale in the Performance Oriented Mobility Assessment for stroke survivors: a retrospective cohort study

  • An, Seungheon;Jee, Youngju;Lee, Donggeon;Song, Sunhae;Lee, Gyuchang
    • Physical Therapy Rehabilitation Science
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    • v.5 no.1
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    • pp.1-8
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    • 2016
  • Objective: The present study was to investigate the discrimination capacity of the Performance Oriented Mobility Assessment-Gait Scale (POMA-GS), for predicting falls in stroke survivors. Design: Retrospective cohort study. Methods: Data including the characteristics and number of falls of 52 chronic stroke patients from a rehabilitation center were collected. The number of falls each subject had experienced in the previous year were investigated through interviews. The subjects were divided into two groups depending on the number of falls: if falls occurred twice or more on the basis of the time of study after stroke, they were defined as the falls group and if there was no fall experience or one fall, they were defined as the non-falls group. The subjects were examined with the POMA-GS, and physical functions were examined using by the One Leg Stand Test (OLST), Sit to Stand Test (SST), 10-m Walk Test, Lower Extremity in Fugl-Meyer assessment (FM-LE), and Trunk Impairment Scale (TIS). The validity of POMA-GS for falls prediction was analyzed. Results: In the POMA-GS, which predicts falls in stroke survivors, the cut-off value was 8.5 (sensitivity 72%; specificity 65%) and the area under the curve was 0.75 (95% confidence interval: 0.60-0.90, p<0.007). There was a significant difference in the OLST, SST, FM-LE, and TIS between the subjects with POMA-GS >8.5 and the subjects with POMA-GS ${\leq}8.5$. Conclusions: The POMA-GS could be a useful tool in predicting falls in stroke survivors, as its discrimination capacity and predictive validity is proven satisfactory.

A Comparison of Assessment Tools for Prediction of Falls in Patients With Stroke (뇌졸중 환자의 낙상 예측을 위한 평가도구 비교)

  • Won, Jong-Im
    • Physical Therapy Korea
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    • v.21 no.2
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    • pp.37-47
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    • 2014
  • Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

Numerical Study and Thrust Prediction of Pintle-Controlled Nozzle with Split-line TVC System (스플릿라인 TVC 시스템을 적용한 핀틀 추력조절 노즐의 유동해석 및 추력 성능 예측)

  • Jo, Hana
    • Journal of the Korean Society of Propulsion Engineers
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    • v.26 no.3
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    • pp.43-53
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    • 2022
  • In this study, analysis of the flow characteristics of pintle-controlled nozzle with split-line TVC system and the thrust performance prediction was performed. The numerical computation was verified by comparing the thrust coefficient derived from the analysis results with the experimental data. By applying the same numerical analysis technique, the flow characteristics of nozzle were confirmed according to operating altitude, pintle stroke position and TVC angle with the 1/10 scale. As the TVC angle increased, thrust loss occurred and the tendency of AF was different depending on the position of the pintle stroke. Based on the analysis results, the relation of thrust coefficient was derived by applying the response surface methods. The thrust performance model with a slight difference of 1.2% on average from the analysis result was generated.