BACKGROUND: Acute ischemic stroke (AIS) has a higher morbidity and mortality 
rate. Many prediction tools have been developed to predict the risk of poor 
outcomes in patients after AIS, such as the THRIVE score, the iScore score, and 
the ASTRAL score. However, the predictive value of above 3 prediction tools in 
Chinese patients with AIS need to be further verified. So, this study aimed to 
determine the ability of the THRIVE score, the iScore score, and the ASTRAL 
score in predicting clinical poor outcomes in Chinese patients with AIS at 1 
year.
METHODS: A total of 772 patients with AIS were included in this study. The 
baseline data of all patients were collected. The THRIVE score, the iScore 
score, and the ASTRAL score were calculated. All patients were followed up at 1 
year. The poor outcome was defined as death, moderate/severe disabilities 
(modified Rankin scale, mRS > 2), most severe disability (mRS ≥ 5). Model 
discrimination was quantified by calculating the area under the receiver 
operating characteristic curve (AUC). The calibration was assessed using 
Hosmer-Lemeshow goodness-of-fit test and Pearson correlation coefficient.
RESULTS: We identified 576 (74.6%) patients with good prognosis and 196 (25.4%) 
patients with poor prognosis. AUC values of THRIVE score in predicting 1-year 
poor prognosis was lower than the iScore score and the ASTRAL scores (P < .05). 
The chi-square values of Hosmer-Lemeshow for the 3 prediction tools were 2.114, 
4.877, 5.838 (all P < .05), respectively. There was a high correlation between 
the observed and the expected poor prognosis (Pearson correlation coefficient, 
.985, .693, and .620; all P < .05). AUC values of THRIVE score in predicting 
1-year mortality and severe disability were lower than the iScore scores (all P 
< .05).
CONCLUSIONS: The iScore score and the ASTRAL score reliably predict 1-year poor 
outcomes in Chinese patients with AIS, and the iScore score can accurately 
predict 1-year mortality and severe disability in Chinese AIS patients.