National Institutes of Health Stroke Scale Score Less Than 10 at 24 hours After Stroke Onset Is a Strong Predictor of a Favorable Outcome After Mechanical Thrombectomy

Abstract

BACKGROUND: There are a few accurate predictors of patient outcomes after mechanical thrombectomy (MT). OBJECTIVE: To investigate whether the National Institutes of Health Stroke Scale (NIHSS) score 24 hours after stroke onset could predict favorable outcomes at 90 days in patients with acute stroke treated with MT. METHODS: Patients from the SKIP study were enrolled in this study. Using receiver operating characteristic curves, the optimal cut-off NIHSS score 24 hours after stroke onset was calculated to distinguish between favorable (modified Rankin Scale score 0-2) and unfavorable (modified Rankin Scale score 3-6) outcomes at 90 days. These receiver operating characteristic curves were compared with those of previously reported predictors of favorable outcomes, such as the ΔNIHSS score (baseline NIHSS score-NIHSS score at 24 h), percent delta (ΔNIHSS score × 100/baseline NIHSS score), and early neurological improvement indices. RESULTS: A total of 177 patients (median age, 72 years; female, 65 [37%]) were enrolled, and 109 (61.9%) had favorable outcomes. The respective sensitivity, specificity, and area under the curve values for an NIHSS of 10 were 92.6%, 80.7%, and .906; a ΔNIHSS score of 7 were 70.6%, 76.1%, and .797; and percent delta of 48.3% were 85.3%, 80.7%, and .890. CONCLUSION: NIHSS score <10 at 24 hours after stroke onset is a strong predictor of favorable outcomes at 90 days in patients treated with MT.

Overexpression of olfactory receptor 78 ameliorates brain injury in cerebral ischaemia–reperfusion rats by activating Prkaca‐mediated cAMP/PKA‐MAPK pathway

“…In this study, a total of 124 patients (57.3 ± 11.5 years) who were diagnosed with acute ischemic stroke in Shaanxi Provincial People's Hospital (Xi'an, China) from June 2020 to February 2023 were included. The inclusion criteria were the first confirmation of ischemic stroke by MRI within 24 h of onset, and the severity of ischemic stroke at admission was assessed according to the National Institutes of Health Stroke Scale [NIHSS] scores (modified Rankin Scale [mRS] scores, 0–1; range, 0 [no symptoms] to 6 [death], with a higher score indicating worse symptoms) 33 . The exclusion criteria were as follows: history of previous stroke, history of other disorders of the nervous system, allergy to radiographic contrast agents, disability prior to stroke occurrence (modified Rankin Scale score >3), pregnant or breastfeeding women, diagnosis 24 h after onset, receipt of thrombolytic therapy, and incomplete information required for analysis.…”

Predictors of failure of early neurological improvement in early time window following endovascular thrombectomy: a multi-center study

“…Mortality was 7.0% in the ENI group in comparison to 42.1% in the FENI group (p < 0.001). The multiple logistic regression model showed that diabetes mellitus [OR (95% CI), 2.985 (1.070-8.324), p = 0.037], pre-stroke mRS [OR (95% CI), 6.221 (1.421-27.248), p = 0.015], last known well to puncture time [OR (95% CI), 1.010 (1.003-1.016), p = 0.002], modified thrombolysis in cerebral infarction = 3 [OR (95%…”

“…Multiple studies have reported that early neurological improvements (ENI) can be used as a surrogate in predicting functional outcomes of AIS patients (5)(6)(7)(8)(9)(10). For example, a decrease in the National Institute of Health Stroke Scale (NIHSS) score of greater than 4 points or NIHSS was 0 or 1 at 24 h after EVT, defined as ENI, was considered as a surrogate of long-term outcomes after mechanical thrombectomy (11).…”