Comparison of Predictive Tools for Recurrence Risk in Patients with Ischemic Stroke

YANG Lirui; YANG Jie; CHANG Lulu; MO Menghui; CHENG Shuxin

doi:10.3969/j.issn.1004-437X.2026.09.007

Abstract：Objective To evaluate the predictive value of three recurrence risk tools,ABCD scoring system,Essen stroke risk score(ESRS),and stroke prognostic instrument-Ⅱ(SPI-Ⅱ)on the recurrence risk of ischemic stroke patients within one year,and to screen the recurrence risk prediction tools suitable for ischemic stroke patients in China.Methods The data of 710 patients with ischemic stroke who were hospitalized in Xinxiang Central Hospital from March 2019 to May 2024 were collected,and 664 patients were included after screening by the inclusion and exclusion criteria.Patients were categorized into the non-recurrent group(584 cases)and the recurrent group(80 cases)according to whether or not they had recurrence within one year.Spearman's method was used to analyze the correlation between ABCD,ESRS,and SPI-Ⅱ scoring tools,and analyze the general information and ABCD,ESRS,and SPI-Ⅱ scores of the recurrence group and the non-recurrence group.Patients were stratified into risk groups according to the assessment criteria of different prediction tools,and the recurrence of ischemic stroke was compared among patients with different risk stratifications.The predictive performance of the ABCD score,ESRS score,and SPI-Ⅱ score for recurrent ischemic stroke was analyzed using the receiver operating characteristic(ROC)curve.Results All of the 664 patients completed one year of follow-up,and 80 patients relapsed during the follow-up period,with a relapse rate of 12.05％.Positive correlations were found between ABCD and ESRS,ABCD and SPI-Ⅱ,and ESRS and SPI-Ⅱ scores(P＜0.05).The proportion of smoking,history of hypertension,and previous cerebral infarctions was elevated in the relapse group when compared with that of the non-relapse group,and the age,ABCD score,ESRS score,and SPI-Ⅱscore were elevated(P＜0.05).The predictive value of ESRS score for recurrence within one year in ischemic stroke patients was higher than that of the other two evaluation tools(P＜0.05).Conclusion The predictive value of ESRS score for recurrence within one year in ischemic stroke patients is higher than that of ABCD score and SPI-Ⅱ score,which helps health care professionals to identify patients at high risk of recurrence early for focused intervention,and provide a reference for early assessment of recurrence risk in such patients by clinical healthcare professionals.