Publication

Raed A. Joundi, Gustavo Saposnik, Rosemary Martino, Jiming Fang, Moira K. Kapral. Development and validation of a prognostic tool for direct enteral tube insertion after acute stroke. Stroke, 2020. Full citation to come with publication.

Cohort

1362 patients with direct enteral tube placement after ischemic stroke or intracerebral hemorrhage in the Ontario Stroke Registry between 2003-2013 (2003-2010 for derivation and 2010-2013 for validation).

Outcome definitions and accuracy

Favourable outcome: Modified Rankin Scale score 0-3 at discharge and alive at 90 days after tube placement; AUC = 0.74 in derivation and 0.84 in validation.

Poor outcome: Modified Rankin Scale score 5 at discharge or death at 90 days after tube placement; AUC = 0.69 in derivation and 0.65 in validation.

30-day mortality after tube placement; AUC = 0.68 in derivation and 0.62 in validation.

Calculator

After the user inputs the relevant baseline characteristics, the calculator will provide a percent probability for each of three outcomes, along with 95% confidence limits. For example, a previously independent 89 year old man with atrial fibrillation who presents with an acute ischemic stroke with NIHSS 18, and has direct enteral tube placement on day 10, has an estimated probability of favourable outcome of 4.4%, probability of poor outcome of poor 72.1% and probability of 30-day mortality of 27.3%.

Disclaimer

The following calculator should be used by physicians only. Information should be communicated to families and patients as deemed appropriate for the clinical setting. This score should not substitute for or supersede clinical decision making and patient/family preferences. The score provides a prognostic estimate only, with limitations in accuracy. Please see the original publication for more specifics on cohort, variables used, composite outcomes, and model performance. The authors of the paper are not liable for any action taken based on information provided by the online calculator.