NIHSS and acute complications after anterior and posterior circulation strokes.
NIHSS and acute complications after anterior and posterior circulation strokes.
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DOI：
10.2147/tcrm.s28569
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发表时间：
2012
影响因子：
2.8
通讯作者：
Bugnicourt JM
中科院分区：
文献类型：
--
作者：
Boone M;Chillon JM;Garcia PY;Canaple S;Lamy C;Godefroy O;Bugnicourt JM
视频本研究的目的是确定美国国立卫生研究院卒中量表（NIHSS）评分是否与后循环梗死患者的院内神经系统和内科并发症（NMC）相关。这项回顾性研究包括一年内入住我们中风病房的所有患者（n = 289）。NMC包括神经功能恶化（即，住院期间NIHSS评分恶化4分或以上）和基于患者病历记录的所有其他医学并发症。79例患者（27%）发生了NMC。在后循环梗死患者（n = 90）中，NMC患者的基线NIHSS评分较高（10.9 vs 2.2，P = 0.004），基线NIHSS评分>2（78% vs 36%，P = 0.003）。在逐步logistic回归中，NIHSS评分>2（比值比：8.2; 95%置信区间：1.64-41.0; P = 0.01）与NMC相关。在前循环梗死患者中观察到类似的结果，但NIHSS评分的截止值较高。在缺血性卒中患者中，基线NIHSS评分增加与NMC风险增加相关。这种关联适用于前循环和后循环卒中，尽管后循环卒中的NIHSS评分为零并不意味着住院期间不存在NMC。这些发现的临床意义需要在更大的前瞻性研究中进一步评估。
Video The purpose of this study was to determine whether the National Institutes of Health Stroke Scale (NIHSS) score was associated with inhospital neurological and medical complications (NMC) in patients with posterior circulation infarction. This retrospective study included all patients admitted to our stroke unit during a one-year period (n = 289). NMC included neurological deterioration (ie, worsening by 4 points or more of the NIHSS score during the hospital stay) and all other medical complications based on what was recorded in the patients’ charts. Seventy-nine patients (27%) experienced NMC. In posterior circulation infarction patients (n = 90), patients with NMC had a higher baseline NIHSS score (10.9 versus 2.2, P = 0.004) and a baseline NIHSS score >2 (78% versus 36%, P = 0.003). In stepwise logistic regression, an NIHSS score >2 (odds ratio: 8.2; 95% confidence interval: 1.64–41.0; P = 0.01) was associated with NMC. Similar results were observed for anterior circulation infarction patients but with a higher cutoff value for NIHSS score. In ischemic stroke patients, an increased baseline NIHSS score was associated with an increased risk of NMC. This association applied to anterior-circulation as well as posterior circulation stroke, although zero on the NIHSS for posterior circulation stroke does not mean the absence of NMC during hospitalization. The clinical significance of these findings requires further evaluation in larger prospective studies.