| Background and Purpose: explore the classification of ischemic cerebral stroke,whether the SSS-TOAST and ASCO can reduce the proportion of patients classified ascause undetermined compared with the TOAST without sacrificing the agreement.Methods: we prospectively assigned300first-ever ischemic stroke patientsconsecutively,for each,the cause of ischemic stroke was classified according to both theTOAST,SSS-TOAST,and ASCO criteria by two stroke physicians. According the result ofthe first physician,Compare the proportion of the same subtype of differentclassifications,and valuing the aggrement of different raters.Results:compared with TOAST, SSS-TOAST could increase the proportion ofatherosclerotic subtype,relative increase11.65%（P﹤0.001）,and of cardio-aortic embolismsubtype,relative increase46.15%（P﹤0.001）, and of small artery disease subtype, relativeincrease30.00%（P﹤0.001）,and of other causes subtype,relative increase81.25%（P﹤0.001）. SSS-TOAST assigned fewer patients as cuase undetermined,relative decrease42.61%（P﹤0.001）. There was no significant difference between the proportion of patientswith undetermined subtype among TOAST and ASCO1.the agreement between the tworaters of TOAST is0.732, of SSS-TOAST is0.915, of ASCO is0.863.Conclusion: SSS-TOAST can reduse the proportion of undetermined subtypewithout sacrificing the agreement ASCO can not decrease the proportion of undeterminedsubtype，but can provide additional information. |
