Progression in acute stroke - Value of the initial NIH Stroke Scale score on patient stratification in future trials
Progression in acute stroke - Value of the initial NIH Stroke Scale score on patient stratification in future trials
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DOI：
10.1161/01.str.30.6.1208
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发表时间：
1999-06-01
期刊：
影响因子：
8.3
通讯作者：
Kelly, BJ
中科院分区：
文献类型：
--
作者：
DeGraba, TJ;Hallenbeck, JM;Kelly, BJ
研究背景和目的：本研究的目的是确定急性脑卒中后48小时内神经系统变化的发生率，因为它与初始脑卒中严重程度有关。方法对127例连续的缺血性脑卒中患者（129例卒中）在前48小时内连续进行美国国立卫生研究院卒中量表（NIHSS）。卒中进展发生率记录（NIHSS评分增加≥ 3分），并进行分析，以确定其与初始卒中严重程度和其他人口统计学和生理学变量的相关性。48小时内的功能缺损消退，定义为NIHSS评分为0或1，测量初始功能缺损预测的功能恢复频率，结果-31%的事件（40/129）出现总体进展。将贝叶斯解决方案应用于观察到的恶化频率，预测未来患者进展的最大可能性发生在NIHSS评分小于或等于7且>7的分层中。初始NIHSS评分≤ 7分的患者恶化率为14.8%（13/88），而评分>7分的患者恶化率为65.9%（27/41）（P7），在此期间检查恢复正常（χ 2，P
Background and Purpose-The objective was to determine the occurrence of neurological changes during the first 48 hours after acute stroke as it relates to initial stroke severity,Methods The National Institutes of Health Stroke Scale (NIHSS) was performed serially for the first 48 hours on 127 consecutive ischemic stroke patients (129 strokes) admitted to the neuroscience intensive care unit. Incidence of stroke progression (a greater than or equal to 3-point increase on the NIHSS) was recorded and analysis performed to determine its association with initial stroke severity and other demographic and physiological variables, Deficit resolution by 48 hours, defined as an NIHSS score of 0 or 1, measured the frequency of functional recovery predicted by the initial deficit,Results-Overall progression was noted in 31% of events (40/129). Applying Bayes' solution to the observed frequency of worsening, the greatest likelihood of predicting future patient progression occurs with stratification at NIHSS scores of less than or equal to 7 and >7. Patients with an initial NIHSS of less than or equal to 7 experienced a 14.8% (13/88) worsening rate versus a those with a score of >7 with a 65.9% (27/41) worsening rate (P7 returned to a normal examination within this period (chi(2), P