TY - JOUR
T1 - NIHSS-time score easily predicts outcomes in rt-PA patients
T2 - The SAMURAI rt-PA registry
AU - Aoki, Junya
AU - Kimura, Kazumi
AU - Koga, Masatoshi
AU - Kario, Kazuomi
AU - Nakagawara, Jyoji
AU - Furui, Eisuke
AU - Shiokawa, Yoshiaki
AU - Hasegawa, Yasuhiro
AU - Okuda, Satoshi
AU - Yamagami, Hiroshi
AU - Okada, Yasushi
AU - Shibazaki, Kensaku
AU - Sakamoto, Yuki
AU - Toyoda, Kazunori
N1 - Funding Information:
Y. Shiokawa receives research support from Daiichi Sankyo Company, Limited. K. Toyoda receives research support from Grants-in-Aid from the Ministry of Health, Labour and Welfare, Japan.
PY - 2013/4/15
Y1 - 2013/4/15
N2 - Background We aimed to devise a scale comprising a simple multiplication of initial National Institutes of Health Stroke Scale (NIHSS) score and onset-to-treatment time (OTT) as a scale for predicting outcomes after recombinant tissue plasminogen activator (rt-PA) therapy. Methods Data from rt-PA patients in 10 stroke centers in Japan were investigated. NIHSS-time score was calculated as initial NIHSS score × OTT. Results Subjects comprised 526 patients. Median NIHSS score was 12 (7-18), and median OTT was 2.42 h (2.00-2.75 h). Median NIHSS-time score was 27.7 (16.9-41.7). Good (modified Rankin Scale [mRS] 0-1) and poor (mRS 4-6) outcome rates at 3 months for patients with NIHSS-time scores ≤ 10 were 71.1% and 7.8%, compared to 54.7% and 16.5% for scores > 10 and ≤ 20, 38.9% and 31.9% for scores > 20 and ≤ 30, 25.0% and 44.6% for scores > 30 and ≤ 40, and 17.4% and 61.8% for scores > 40, respectively. Cut-off NIHSS-time scores to predict good and poor outcomes with 50% probability were defined as 20 and 40, respectively. Multivariate logistic regression analysis revealed NIHSS-time score as an independent predictor of good (odds ratio [OR], 0.587; 95% confidence interval [CI], 0.422-0.818, p = 0.002) and poor (OR, 1.756; 95%CI, 1.227-2.514, p = 0.002) outcomes after adjusting for age, sex, NIHSS score, OTT, Alberta Stroke Program Early CT Score, internal carotid artery occlusion, and glucose level. Conclusions NIHSS-time score predicts clinical outcomes in rt-PA patients.
AB - Background We aimed to devise a scale comprising a simple multiplication of initial National Institutes of Health Stroke Scale (NIHSS) score and onset-to-treatment time (OTT) as a scale for predicting outcomes after recombinant tissue plasminogen activator (rt-PA) therapy. Methods Data from rt-PA patients in 10 stroke centers in Japan were investigated. NIHSS-time score was calculated as initial NIHSS score × OTT. Results Subjects comprised 526 patients. Median NIHSS score was 12 (7-18), and median OTT was 2.42 h (2.00-2.75 h). Median NIHSS-time score was 27.7 (16.9-41.7). Good (modified Rankin Scale [mRS] 0-1) and poor (mRS 4-6) outcome rates at 3 months for patients with NIHSS-time scores ≤ 10 were 71.1% and 7.8%, compared to 54.7% and 16.5% for scores > 10 and ≤ 20, 38.9% and 31.9% for scores > 20 and ≤ 30, 25.0% and 44.6% for scores > 30 and ≤ 40, and 17.4% and 61.8% for scores > 40, respectively. Cut-off NIHSS-time scores to predict good and poor outcomes with 50% probability were defined as 20 and 40, respectively. Multivariate logistic regression analysis revealed NIHSS-time score as an independent predictor of good (odds ratio [OR], 0.587; 95% confidence interval [CI], 0.422-0.818, p = 0.002) and poor (OR, 1.756; 95%CI, 1.227-2.514, p = 0.002) outcomes after adjusting for age, sex, NIHSS score, OTT, Alberta Stroke Program Early CT Score, internal carotid artery occlusion, and glucose level. Conclusions NIHSS-time score predicts clinical outcomes in rt-PA patients.
KW - Acute stroke
KW - NIHSS score
KW - Onset to treatment time
KW - Thrombolysis
UR - https://www.scopus.com/pages/publications/84875217375
U2 - 10.1016/j.jns.2013.01.029
DO - 10.1016/j.jns.2013.01.029
M3 - Article
C2 - 23433814
AN - SCOPUS:84875217375
SN - 0022-510X
VL - 327
SP - 6
EP - 11
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
IS - 1-2
ER -