National Institutes of Health Stroke Scale-Time Score Predicts Outcome after Endovascular Therapy in Acute Ischemic Stroke: A Retrospective Single-Center Study

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• 作者：Kenichi Todo ; MD^* ; ^{ktodo@kcho.jp" class="auth_mail" title="E-mail the corresponding author} ; Nobuyuki Sakai ; MD^&dagger ; ; Tomoyuki Kono ; MD^* ; Taku Hoshi ; MD^* ; Hirotoshi Imamura ; MD^&dagger ; ; Hidemitsu Adachi ; MD^&dagger ; ; Nobuo Kohara ; MD^*
• 关键词：Ischemic stroke ; endovascular therapy ; outcome predictive factors ; endovascular recanalization ; revascularization
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：25
• 期：5
• 页码：1187-1191
• 全文大小：522 K

文摘

Outcomes after successful endovascular therapy in acute ischemic stroke are associated with onset-to-reperfusion time (ORT) and the National Institutes of Health Stroke Scale (NIHSS) score. In intravenous recombinant tissue plasminogen activator therapy, the NIHSS–time score, calculated by multiplying onset-to-treatment time with the NIHSS score, has been shown to predict clinical outcomes. In this study, we assessed whether a similar combination of the ORT and the NIHSS score can be applied to predict the outcomes after endovascular therapy.

<h4 id="absSec_2">Methodsh4>

We retrospectively reviewed the charts of 128 consecutive ischemic stroke patients with successful reperfusion after endovascular therapy. We analyzed the association of the ORT, the NIHSS score, and the NIHSS&ndash;time score with good outcome (modified Rankin Scale score&thinsp;≤&thinsp;2 at 3 months).

<h4 id="absSec_3">Resultsh4>

Good outcome rates for patients with NIHSS&ndash;time scores of 84.7 or lower, scores higher than 84.7 up to 127.5 or lower, and scores higher than 127.5 were 72.1%, 44.2%, and 14.3%, respectively (P&thinsp;<&thinsp;.01). Multivariate logistic regression analysis revealed that the NIHSS&ndash;time score was an independent predictor of good outcomes (odds ratio, .372; 95% confidence interval, .175-.789) after adjusting for age, sex, internal carotid artery occlusion, plasma glucose level, ORT, and NIHSS score.

<h4 id="absSec_4">Conclusionsh4>

The NIHSS&ndash;time score can predict good clinical outcomes after endovascular treatment.