Journal article
Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the trial of Org 10172 in Acute Stroke Treatment (TOAST)
Neurology, Vol.53(1), pp.126-131
1999
DOI: 10.1212/WNL.53.1.126
PMID: 10408548
Abstract
Objective: To compare the baseline National Institutes of Health Stroke Scale (NIHSS) score and the Trial of Org 10172 in Acute Stroke Treatment (TOAST) stroke subtype as predictors of outcomes at 7 days and 3 months after ischemic stroke.
Methods: Using data collected from 1,281 patients enrolled in a clinical trial, subtype of stroke was categorized using the TOAST classification, and neurologic impairment at baseline was quantified using the NIHSS. Outcomes were assessed at 7 days and 3 months using the Barthel Index (BI) and the Glasgow Outcome Scale (GOS). An outcome was rated as excellent if the GOS score was 1 and the BI was 19 or 20 (scale of 0 to 20). Analyses were adjusted for age, sex, race, and history of previous stroke.
Results: The baseline NIHSS score strongly predicted outcome, with one additional point on the NIHSS decreasing the likelihood of excellent outcomes at 7 days by 24% and at 3 months by 17%. At 3 months, excellent outcomes were noted in 46% of patients with NIHSS scores of 7 to 10 and in 23% of patients with scores of 11 to 15. After multivariate adjustment, lacunar stroke had an odds ratio of 3.1 (95% CI, 1.5 to 6.4) for an excellent outcome at 3 months.
Conclusions: The NIHSS score strongly predicts the likelihood of a patient's recovery after stroke. A score of >=16 forecasts a high probability of death or severe disability whereas a score of <=6 forecasts a good recovery. Only the TOAST subtype of lacunar stroke predicts outcomes independent of the NIHSS score.
Details
- Title: Subtitle
- Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the trial of Org 10172 in Acute Stroke Treatment (TOAST)
- Creators
- H. P ADAMS - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesP. H DAVIS - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesE. C LEIRA - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesK.-C CHANG - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesB. H BENDIXEN - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, Iowa City, IA, United StatesW. R CLARKE - Division of Biostatistics, Department of Preventive Medicine, University of Iowa College of Medicine, Iowa City, IA, United StatesR. F WOOLSON - Division of Biostatistics, Department of Preventive Medicine, University of Iowa College of Medicine, Iowa City, IA, United StatesM. D HANSEN - Division of Biostatistics, Department of Preventive Medicine, University of Iowa College of Medicine, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Neurology, Vol.53(1), pp.126-131
- Publisher
- Lippincott Williams & Wilkins; Hagerstown, MD
- DOI
- 10.1212/WNL.53.1.126
- PMID
- 10408548
- ISSN
- 0028-3878
- eISSN
- 1526-632X
- Language
- English
- Date published
- 1999
- Academic Unit
- Statistics and Actuarial Science; Neurology; Epidemiology; Iowa Neuroscience Institute; Biostatistics; Neurosurgery
- Record Identifier
- 9984020705102771
Metrics
44 Record Views