Interconversion of the National Institutes of Health Stroke Scale and Scandinavian Stroke Scale in Acute Stroke

Gray, Laura J.; Ali, Myzoon; Lyden, Patrick D.; Bath, Philip M.W.

doi:10.1016/j.jstrokecerebrovasdis.2009.02.003

Cited by 82 publications

(77 citation statements)

References 5 publications

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“…Moreover, the National Institutes of Health Stroke Scale (NIHSS) to evaluate neurological severity upon admission [21] and the Scandinavian Stroke Scale (SSS) [22] were added to our stroke data bank [18]. For the purpose of the present study, the NIHSS score for the period from 1993 to 1998 was calculated from the SSS using the formula: NIHSS = 25.68 – (0.43 × SSS) [23]. A brain CT scan and a 12-lead electrocardiogram were immediately performed.…”

Section: Methodsmentioning

confidence: 99%

Temporal Trends and Associated Factors for Pre-Hospital and In-Hospital Delays of Stroke Patients over a 16-Year Period: The Athens Study

et al. 2010

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Background: The management and outcome of acute ischemic stroke changed dramatically after the introduction of intravenous thrombolysis. However, relatively few patients have received thrombolytic treatment, mainly due to pre-hospital and/or in-hospital delays. Although the causes of these delays have been adequately studied, their change over a long period has not. Methods: All acute first-ever stroke patients (n = 2,746) presenting to our academic center from 1993 to 2008 were prospectively documented in a computerized stroke data bank. The time from symptoms onset to presentation at the emergency room and to acquisition of a brain CT was calculated. Time trends over this period as well as the factors affecting them were analyzed. Results: The final study cohort consisted of 2,326 acute stroke patients after excluding 302 patients with an unknown time of stroke onset and 118 who suffered a stroke during hospitalization for another illness. Over the 16-year period, the median time from stroke onset to presentation at the emergency room decreased significantly from 3.15 h (interquartile range 1.30–10.30) to 2.00 h (range 1.00–4.00) (p < 0.001). The median time from emergency room presentation to CT scan completion also decreased significantly (p < 0.001) from 12.3 h (range 4.1–29.8) to 1.0 h (range 0.31–2.77). As a result, the proportion of patients having a CT scan within 4 h of stroke onset increased significantly from 8.6% in 1993–1994 to 53.6% in 2007–2008 (p < 0.001). Thrombolytic treatment was applied in 4.15% of all ischemic stroke patients in the period from 2003 to 2008. Along with other significant factors, use of an emergency medical service was associated with a 57% greater chance of presenting within 3 h after symptoms onset. Conclusions: These results suggest a continued improvement in pre-hospital and in-hospital delays for stroke management. Public awareness and education regarding medical and paramedical services are necessary for the best early management of acute stroke patients.

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Section: Methodsmentioning

confidence: 99%

Temporal Trends and Associated Factors for Pre-Hospital and In-Hospital Delays of Stroke Patients over a 16-Year Period: The Athens Study

et al. 2010

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“…The cut point of 4 SIP score points was made based on the widely accepted 4 point NIHSS cut point 3 19 when defining ND and the conversion formula between the Scandinavian Stroke Scale and NIHSS. 20 END was defined as occurring within the first 24 h after admission, 3 18 19 21 with the admission value of GCS and SIP score as the baseline reference. The presence of END was confirmed based on the documented GCS and SIP score values along with medical chart descriptions.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Prediction and prognostication of neurological deterioration in patients with acute ICH: a hospital-based cohort study

et al. 2015

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ObjectivePatients with intracerebral haemorrhage (ICH) are at high risk of neurological deterioration (ND). We aimed at establishing predictors of early ND (END) as well as late ND (LND) and at exploring the impact of neurological stability during the first week on long-term prognosis.DesignWe conducted this study as a retrospective cohort study. ND was evaluated based on the consciousness and severity of neurological symptoms. ND during the first 24 h after admission was defined as early ND and from 24 h to 7 days as LND. Patients were followed up until February 2015.ParticipantsWe included 300 patients with acute ICH (≤4.5 h from symptom onset) who were admitted to our institution from March 2009 to January 2015.SettingSection of Acute Neurology, Department of Neurology, Bispebjerg Hospital is a specialised referral centre receiving patients with acute stroke from the entire capital region of Denmark.ResultsWe found that a spot sign on CT angiography (OR 10.7 CI 4.79 to 24.3) and extensive degree of interventricular haemorrhage (IVH) (OR 8.73 CI 2.87 to 26.5) were independent predictors of END, whereas a degree of comorbidity (Charlton Index), admission stroke severity and degree of IVH predicted LND. On follow-up imaging, haematoma expansion was independently associated with END (OR 6.1 CI 2.2 to 17.3), and expansion of IVH was independently associated with both END (OR 1.7 CI 1.2 to 2.3 per point increase) and LND (OR 2.3 CI 1.3 to 4.2 per point increase). ND during the first week was associated with a 1-year mortality of 60.5%, compared with 9.2% among the patients who remained stable.ConclusionsThese results suggest that stability during the first week entails an optimistic prognosis. A relatively easy and effective risk stratification of END and LND is possible on admission based on the spot sign, IVH and clinical parameters.

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“…For the study period between 1993 and 1998, NIHSS score was calculated from the Scandinavian Stroke Scale using the following formula: NIHSS scoreϭ25.68Ϫ(0.43ϫScandinavian Stroke Scale score). 24 A brain CT scan and a 12-lead ECG were immediately performed. A second CT or MRI scan was performed within the first week.…”

Section: Data Selectionmentioning

confidence: 99%

Association Between Obesity and Mortality After Acute First-Ever Stroke

Vemmos

Ntaios

Spengos

et al. 2011

Stroke

293

191

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Background and Purpose-Limited data exist concerning obesity and survival in patients after acute stroke. The objective of this study was to investigate the association between obesity and survival in patients with acute first-ever stroke. Methods-Patients were prospectively investigated based on a standard diagnostic protocol over a period of 16 years.Evaluation was performed on admission, at 7 days, at 1, 3, and 6 months after discharge, and yearly thereafter for up to 10 years after stroke. The study patients were divided into 3 groups according to body mass index (BMI): normal weight (Ͻ25 kg/m 2 ), overweight (25-29.9 kg/m 2 ), and obese (Ն30 kg/m 2 ). Overall survival during follow-up was the primary end point. The secondary end point was the overall composite cardiovascular events over the study period.Results-Based on our inclusion criteria, 2785 patients were recruited. According to BMI, 1138 (40.9%)

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Interconversion of the National Institutes of Health Stroke Scale and Scandinavian Stroke Scale in Acute Stroke

Cited by 82 publications

References 5 publications

Temporal Trends and Associated Factors for Pre-Hospital and In-Hospital Delays of Stroke Patients over a 16-Year Period: The Athens Study

Temporal Trends and Associated Factors for Pre-Hospital and In-Hospital Delays of Stroke Patients over a 16-Year Period: The Athens Study

Prediction and prognostication of neurological deterioration in patients with acute ICH: a hospital-based cohort study

Association Between Obesity and Mortality After Acute First-Ever Stroke

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