The National Institutes of Health Stroke Scale is comparable to the ICH score in predicting outcomes in spontaneous acute intracerebral hemorrhage.

NIHSS clinical trial clinimetrics intracerebral hemorrhage prognosis

Journal

Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899

Informations de publication

Date de publication:
2024
Historique:
received: 15 03 2024
accepted: 11 06 2024
medline: 16 7 2024
pubmed: 16 7 2024
entrez: 16 7 2024
Statut: epublish

Résumé

Validating the National Institutes of Health NIH Stroke Scale (NIHSS) as a tool to assess deficit severity and prognosis in patients with acute intracerebral hemorrhage would harmonize the assessment of intracerebral hemorrhage (ICH) and acute ischemic stroke (AIS) patients, enable clinical use of a readily implementable and non-imaging dependent prognostic tool, and improve monitoring of ICH care quality in administrative datasets. Among randomized trial ICH patients, the relation between NIHSS scores early after Emergency Department arrival and 3-month outcomes of dependency or death (modified Rankin Scale, mRS 3-6) and case fatality was examined. NIHSS predictive performance was compared to a current standard prognostic scale, the intracerebral hemorrhage score (ICH score). Among the 384 patients, the mean age was 65 (±13), with 66% being male. The median NIHSS score was 16 (interquartile range (IQR) 9-25), the mean initial hematoma volume was 29 mL (±38), and the ICH score median was 1 (IQR 0-2). At 3 months, the mRS had a median of 4 (IQR 2-6), with dependency or death occurring in 70% and case fatality in 26%. The NIHSS and ICH scores were strongly correlated ( The NIHSS forecasts 3-month functional and case fatality outcomes with accuracy comparable to the ICH Score. Widely documented in routine clinical care and administrative data, the NIHSS can serve as a valuable measure for clinical prognostication, therapy development, and case-mix risk adjustment in ICH patients.

Sections du résumé

Background UNASSIGNED
Validating the National Institutes of Health NIH Stroke Scale (NIHSS) as a tool to assess deficit severity and prognosis in patients with acute intracerebral hemorrhage would harmonize the assessment of intracerebral hemorrhage (ICH) and acute ischemic stroke (AIS) patients, enable clinical use of a readily implementable and non-imaging dependent prognostic tool, and improve monitoring of ICH care quality in administrative datasets.
Methods UNASSIGNED
Among randomized trial ICH patients, the relation between NIHSS scores early after Emergency Department arrival and 3-month outcomes of dependency or death (modified Rankin Scale, mRS 3-6) and case fatality was examined. NIHSS predictive performance was compared to a current standard prognostic scale, the intracerebral hemorrhage score (ICH score).
Results UNASSIGNED
Among the 384 patients, the mean age was 65 (±13), with 66% being male. The median NIHSS score was 16 (interquartile range (IQR) 9-25), the mean initial hematoma volume was 29 mL (±38), and the ICH score median was 1 (IQR 0-2). At 3 months, the mRS had a median of 4 (IQR 2-6), with dependency or death occurring in 70% and case fatality in 26%. The NIHSS and ICH scores were strongly correlated (
Conclusion UNASSIGNED
The NIHSS forecasts 3-month functional and case fatality outcomes with accuracy comparable to the ICH Score. Widely documented in routine clinical care and administrative data, the NIHSS can serve as a valuable measure for clinical prognostication, therapy development, and case-mix risk adjustment in ICH patients.

Identifiants

DOI: 10.3389/fneur.2024.1401793 PMID: 39011360 PMC: PMC11246900
pubmed: 39011360
doi: 10.3389/fneur.2024.1401793
pmc: PMC11246900
doi:

Banques de données

ClinicalTrials.gov
['NCT00059332']

Types de publication

Journal Article

Langues

eng

Pagination

1401793

Informations de copyright

Copyright © 2024 Kazaryan, Shkirkova, Saver, Liebeskind, Starkman, Bulic, Poblete, Kim-Tenser, Guo, Conwit, Villablanca, Hamilton and Sanossian.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Auteurs

Suzie A Kazaryan (SA)

Roxanna Todd Hodges Comprehensive Stroke Program, Department of Neurology, University of Southern California, Los Angeles, CA, United States.

Kristina Shkirkova (K)

Roxanna Todd Hodges Comprehensive Stroke Program, Department of Neurology, University of Southern California, Los Angeles, CA, United States.

Jeffrey L Saver (JL)

Comprehensive Stroke Center and Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States.

David S Liebeskind (DS)

Comprehensive Stroke Center and Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States.

Sidney Starkman (S)

Comprehensive Stroke Center and Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States.

Sebina Bulic (S)

Roxanna Todd Hodges Comprehensive Stroke Program, Department of Neurology, University of Southern California, Los Angeles, CA, United States.

Roy Poblete (R)

Roxanna Todd Hodges Comprehensive Stroke Program, Department of Neurology, University of Southern California, Los Angeles, CA, United States.

May Kim-Tenser (M)

Roxanna Todd Hodges Comprehensive Stroke Program, Department of Neurology, University of Southern California, Los Angeles, CA, United States.

Shujing Guo (S)

Comprehensive Stroke Center and Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States.

Robin Conwit (R)

National Institutes of Health, Bethesda, MD, United States.
Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, United States.

Pablo Villablanca (P)

Comprehensive Stroke Center and Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States.

Scott Hamilton (S)

Department of Neurology, Stanford University, Stanford, CA, United States.

Nerses Sanossian (N)

Roxanna Todd Hodges Comprehensive Stroke Program, Department of Neurology, University of Southern California, Los Angeles, CA, United States.

Classifications MeSH