Predictors of outcome after acute ischemic stroke*

Sümer, Murat; Ozdemir, I.; Taşçılar, Nida

doi:10.1034/j.1600-0404.2003.02008.x

Cited by 21 publications

(17 citation statements)

References 33 publications

(39 reference statements)

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“…The most dominant finding is that the severity of neurological or functional disability immediately after the stroke has a major influence 3, 4, 5, 6, 7, 8, 9, 28, 29. This has been demonstrated universally and it is also a main finding in our study.…”

Section: Discussionsupporting

confidence: 73%

“…This has been demonstrated universally and it is also a main finding in our study. In addition higher age,3, 5, 8, 9 female sex,5, 19, 21, 22, 23, 24, 25, 26, 27 prior cerebrovascular disease,3, 5, 8 peripheral artery disease,7 arm paresis,5 diabetes,5, 7 fever,5 TOAST‐classification 4, 28 and infarct location,5, 6, 28 among others, have been reported to be negative predictors. The main results in our study thus are consistent with previous findings, emphasising especially stroke severity and prior cerebrovascular disease in addition to age and sex.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of disability and reduced functional capacity after stroke is aetiologically multifactorial. The severity of the initial neurologic affection has been established as a main determinant, and some other variables as sex, age, previous cerebrovascular disease and previous peripheral artery disease are frequently reported to be important predictors,3, 4, 5, 6, 7, 8, 9 but more specific knowledge about other possible predictive factors is needed in order to optimise stroke outcome.…”

Section: Introductionmentioning

confidence: 99%

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Subjective health complaints predict functional outcome six months after stroke

et al. 2016

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ObjectivesCerebrovascular stroke is a main cause of lasting disability in older age, and initial stroke severity has been established as a main determinant for the degree of functional loss. In this study, we searched for other predictors of functional outcome in a cohort of stroke patients participating in an early supported discharge randomised controlled trial.MethodsThirty candidate variables related either to premorbid history or to the acute stroke were examined by ordered logistic regression in 229 stroke patients. Dependent variables were modified Rankin Scale (mRS) at 6 months and mRS change from baseline to 6 months.ResultsFor mRS at 6 months, Barthel Index at stable baseline post‐stroke was the main predictor, with sex, age, previous cerebrovascular disease, previous peripheral artery disease and the necessity for tube feeding in the acute phase also contributing to the final model. For mRS change, only age and previous cerebrovascular disease were significant predictors. Prestroke subjective health complaints added significantly to all final models concurrently with sex losing its predictive power.ConclusionsInitial stroke severity was the main predictor of functional outcome. Subjective health complaints score was a potent predictor for both outcome and improvement from baseline to 6 months and at the same time ameliorated the predictive impact of sex. The poorer functional prognosis for women after stroke may therefore be related to their higher load of subjective health complaints rather than to their sex itself. Treating these complaints may possibly improve the functional prognosis.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subjective health complaints predict functional outcome six months after stroke

et al. 2016

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“…Potential candidate predictors were identified in the literature and selected according to clinical relevance and availability [2,5,6,14,21]. The selected variables were vital signs at hospital presentation or data extractable within the first 24 hours, such as demographics, presenting clinical features, laboratory values, and pre-existing comorbidity.…”

Section: Predictors Of Mortality and Definitionsmentioning

confidence: 99%

Derivation and validation of a simple risk score for predicting 1-year mortality in stroke

et al. 2007

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“…20,29 -34 As would be reasonably expected, improved brain perfusion and recanalization after thrombolytic therapy are also associated with improved mRS disability outcomes. 21,33,35,36 For example, in a study of 177 acute ischemic stroke patients, recanalization within 5 hours post-recombinant tissue plasminogen activator treatment (in addition to National Institutes of Health Stroke Scale [NIHSS] baseline scores and other factors) 20 -22,37 Canadian Neurological Scale, 26,38 Mathew scale, 31 Los Angeles Motor Scale, 39 or European Stroke Scale 40 ) independently predict mRS grade at 2 months to 1 year poststroke (detail in supplemental Table I). For example, Demchuk and coworkers observed that patients with the mildest strokes (NIHSS score 1 to 5) compared with those with more severe strokes (NIHSS scores 11 to 15, 16 to 20, Ͼ20) had improved chances of achieving a favorable outcome defined by mRS grade 0 to 1 (95% CIϭ0.02 to 0.16, PϽ0.001; 95% CIϭ0.13 to 0.56, PϽ0.001; 95% CIϭ0.20 to 0.79, Pϭ0.008, respectively).…”

Section: Construct Validity: Relationship To Stroke Severitymentioning

confidence: 99%

Outcomes Validity and Reliability of the Modified Rankin Scale: Implications for Stroke Clinical Trials

Banks

Marotta

2007

Stroke

1,667

1,105

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Background and Purpose-The modified Rankin scale (mRS), a clinician-reported measure of global disability, is widely applied for evaluating stroke patient outcomes and as an end point in randomized clinical trials. Extensive evidence on the validity of the mRS exists across a large but fragmented literature. As new treatments for acute ischemic stroke are submitted for agency approval, an appreciation of the mRS's attributes, specifically its relationship to other stroke evaluation scales, would be valuable for decision-makers to properly assess the impact of a new drug on treatment paradigms. The purpose of this report is to assemble and systematically assess the properties of the mRS to provide decision-makers with pertinent evaluative information. Methods-A Medline search was conducted to identify reports in the peer-reviewed medical literature that provide information on the structure, validation, scoring, and psychometric properties of the mRS and its use in clinical trials. The selection of articles was based on defined criteria that included relevance, study design and use of appropriate statistical methods. Results-Of 224 articles identified by the literature search, 50 were selected for detailed assessment. Inter-rater reliability with the mRS is moderate and improves with structured interviews ( 0.56 versus 0.78); strong test-re-test reliability (ϭ0.81 to 0.95) has been reported. Numerous studies demonstrate the construct validity of the mRS by its relationships to physiological indicators such as stroke type, lesion size, perfusion and neurological impairment. Convergent validity between the mRS and other disability scales is well documented. Patient comorbidities and socioeconomic factors should be considered in properly applying and interpreting the mRS. Recent analyses suggest that randomized clinical trials of acute stroke treatments may require a smaller sample size if the mRS is used as a primary end point rather than the Barthel Index. Conclusions-Multiple types of evidence attest to the validity and reliability of the mRS. The reported data support the view that the mRS is a valuable instrument for assessing the impact of new stroke treatments.

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Predictors of outcome after acute ischemic stroke*

Abstract: Severity of neurologic deficit is the most important indicator for clinical outcome in acute ischemic stroke both at short-term and at sixth month, whereas posterior circulation infarction also predicts a poor outcome at discharge.

Cited by 21 publications

References 33 publications

Subjective health complaints predict functional outcome six months after stroke

Subjective health complaints predict functional outcome six months after stroke

Derivation and validation of a simple risk score for predicting 1-year mortality in stroke

Outcomes Validity and Reliability of the Modified Rankin Scale: Implications for Stroke Clinical Trials

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