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J Stroke Cerebrovasc Dis. 2016 Apr;25(4):819-24. doi: 10.1016/j.jstrokecerebrovasdis.2015.12.003. Epub 2016 Jan 18.

The Ischemic Stroke Predictive Risk Score Predicts Early Neurological Deterioration.

Author information

1
Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea; Stroke Outcomes Research Unit, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
2
Department of Neurology, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Kangdong, Seoul, Republic of Korea.
3
Department of Neurology, Changwon Fatima Hospital, Changwon, Republic of Korea.
4
Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
5
Stroke Outcomes Research Unit, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address: saposnikg@smh.ca.

Abstract

BACKGROUND:

Although early neurological deterioration (END) during the acute stroke period is known to be directly associated with poor short- and long-term outcomes, few studies have investigated the ability to predict END. The aim of this study was to investigate whether there are differences in the occurrence of END according to the ischemic stroke predictive risk score (iScore), which was developed to predict short- and long-term mortality.

METHODS:

We collected data from 2150 consecutive ischemic stroke patients who were admitted to 3 study hospitals between January 2012 and June 2014. END was defined as an increase (≥4) in the National Institutes of Health Stroke Scale score within the first 72 hours of stroke onset. We calculated the 30-day iScore for each patient to determine the relationship between the iScore and occurrence of END.

RESULTS:

Among 2150 patients, END was observed in 146 patients (6.8%). There was a positive correlation between the iScore and occurrence of END. After adjusting for potential confounders, the iScore was independently associated with END (odds ratio: 1.217 per 20-point increase in iScore, 95% confidence interval: 1.121-1.321, P < .001). There was good correlation between observed and expected outcomes predicted by the iScore (Pearson correlation coefficient: r = .950, P < .001).

CONCLUSIONS:

The iScore can predict the risk of END development within the acute stroke stage.

KEYWORDS:

Ischemic stroke; outcome; prediction; risk score

[Indexed for MEDLINE]

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