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Validity of the NIHSS in predicting arterial occlusion in cerebral infarction is time-dependent

Show simple item record Delgado, Iris Hoppe, Arnold Brunser, Alejandro Cárcamo, Daniel Lavados, Pablo Olavarría, Verónica Díaz Tapia, V. 2016-12-07T16:44:29Z 2016-12-07T16:44:29Z 2011
dc.identifier.citation Neurology, 2011, vol.76, n° 1, p. 62-68 es_CL
dc.identifier.uri es_CL
dc.description.abstract Background: The NIH Stroke Scale (NIHSS) is used to assess acute ischemic stroke severity and outcome. High NIHSS scores are usually associated with arterial occlusion but it is unknown what the effect of time to clinical evaluation (TTCE) in this association is. We tested the NIHSS scores as an instrument to determine vessel occlusion (VO) at different time points from symptom onset. Methods: Patients were selected from our prospective stroke database if they had admission NIHSS scores and intracranial vessel neuroimaging studies. We dichotomized patients according to VO and TTCE. Receiver operating curves, c statistics, and odds ratios were calculated to study the validity of the NIHSS score. Results: Among 463 patients (mean age 70.2 years, 53.1% male, median NIHSS 4, median TTCE 3.3 hours), 22.5% had arterial occlusion. Median NIHSS scores were higher in patients with VO, 10.5 (interquartile range 5-18) vs 3 (2-7), p < 0.001, and in those with TTCE < 6 hours, 15 (interquartile range 7-19) vs 4 (2-8) if >= 6 hours, p < 0.001. Receiver operating characteristic curves showed that the validity of NIHSS in predicting VO was higher in patients with TTCE < 6 hours, p = 0.03. The best cutoff point in patients evaluated before 6 hours was an NIHSS of 7 (76.2% sensitivity, specificity 70.1%), while in patients evaluated after 6 hours the best cutoff point was 4 (sensitivity 65.4%, specificity 62.0%). Conclusions: Our study shows that the validity of NIHSS scores in predicting arterial occlusion is time-dependent, decreasing with increasing time from symptom onset to clinical evaluation. Neurology (R) 2011; 76:62-68 es_CL
dc.language.iso en_US es_CL
dc.subject Acute ischemic-stroke es_CL
dc.subject Vessel Intracranial Occlusion es_CL
dc.subject Tissue-plasminogen activator es_CL
dc.subject Scale score es_CL
dc.subject CT Angiography es_CL
dc.subject Accuracy es_CL
dc.subject Impact es_CL
dc.subject Trial es_CL
dc.subject Recanalization es_CL
dc.subject Management es_CL
dc.title Validity of the NIHSS in predicting arterial occlusion in cerebral infarction is time-dependent es_CL
dc.type Artículo es_CL

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