The adaption and evaluation of a Latvian version of the National Institutes of Health Stroke Scale

Jurjāns, Kristaps; Noviks, Iļja; Volčeka, Diāna; Zandersone, Linda; Meilerte, Kristine; Miglāne, Evija; Stepens, Ainārs; Millers, Andrejs

doi:10.1177/0300060516664636

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…Our findings are consistent with those of other studies in this topic; however, we noted higher individual item agreement values than those reported by most other investigators. Only one report by Jurjans et al [ 26 ] found that all the items of a Latvian validated tool achieved excellent ICC (> 0.95) in both inter-rater and intra-rater assessments. The authors of validation reports of other scales found moderate, and sometimes, even poor agreement between the selected items [ 9 – 15 ].…”

Section: Discussionmentioning

confidence: 99%

Validation of a Polish version of the National Institutes of Health Stroke Scale: Do moderate psychometric properties affect its clinical utility?

et al. 2021

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Background The National Institutes of Health Stroke Scale (NIHSS) is a validated tool for assessing the severity of stroke. It has been adapted into several languages; however, a Polish version with large-scale psychometric validation, including repeatability and separate assessments of anterior and posterior stroke, has not been developed. We aimed to adapt and validate a Polish version of the NIHSS (PL-NIHSS) while focusing on the psychometric properties and site of stroke. Methods The study included 225 patients with ischemic stroke (102 anterior and 123 posterior circulation stroke). Four NIHSS-certified researchers estimated stroke severity using the most appropriate scales to assess the psychometric properties (including internal consistency, homogeneity, scalability, and discriminatory power of individual items) and ultimately determine the reliability, repeatability, and validity of the PL-NIHSS. Results The PL-NIHSS achieved Cronbach’s alpha coefficient of 0.6885, which indicates moderate internal consistency and homogeneity. Slightly more than half of the individual items provided sufficient discriminatory power (r > 0.3). A favorable coefficient of repeatability (0.6267; 95% confidence interval: 0.5737–0.6904), narrow limits of inter-rater agreement, and excellent intraclass correlation coefficients or weighted kappa values (> 0.90), demonstrated high reliability of PL-NIHSS. Highly significant correlations with other tools confirmed the validity and predictive value of the PL-NIHSS. In posterior stroke, the PL-NIHSS achieved the required Cronbach’s alpha coefficient (0.71070). Additionally, stroke location did not affect other psychometric features or instrument reliability and validity. Conclusions We developed a valid and reliable tool for assessing stroke severity in Polish-speaking participants. Moderate psychometric features were emphasized without limiting its clinical applications.

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Section: Discussionmentioning

confidence: 99%

Validation of a Polish version of the National Institutes of Health Stroke Scale: Do moderate psychometric properties affect its clinical utility?

et al. 2021

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“…We used the modified Rankin scale (mRS) and the Latvian version of the National Institute of Health Stroke Scale (LV-NIHSS) to measure the functional and neurological outcomes of patients [ 10 , 11 ].…”

Section: Methodsmentioning

confidence: 99%

Idarucizumab in Dabigatran-Treated Patients with Acute Ischemic Stroke Receiving Thrombolytic Therapy

et al. 2022

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Background and Objectives: Thrombolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) is used to treat acute ischemic stroke. Dabigatran is a reversible thrombin inhibitor approved for stroke prevention in patients with nonvalvular atrial fibrillation. In such cases, thrombolytic therapy can be administered to certain patients after idarucizumab treatment. We evaluated the effectiveness of idarucizumab in dabigatran-treated patients receiving rt-PA. Materials and Methods: We included the data of nine idarucizumab-treated patients from the Riga East University Hospital Stroke Registry from 2018 to 2022 in our retrospective medical records analysis. We used the National Institutes of Health Stroke Scale (LV-NIHSS) score and modified Rankin scale (mRS) on admission and discharge to evaluate neurological deficit and functional outcomes. Results: We analyzed the data of nine patients (seven males and two females) with a mean age of 75.67 ± 8.59 years. The median door-to-needle time for all patients, including those who received idarucizumab before rt-PA, was 51 min (IQR = 43–133); the median LV-NIHSS score was 9 (IQR = 6.0–16.0) on admission and 4 (IQR = 2.5–4.0) at discharge; and the intrahospital mortality rate was 11.1% due to intracranial hemorrhage as a complication of rt-PA. Conclusions: Our study shows that idarucizumab as an antidote of dabigatran appears to be effective and safe in patients with acute ischemic stroke. Furthermore, the administration of idarucizumab slightly prolongs the door-to-needle time; however, the majority of cases showed clinical improvement after receiving therapy. Further randomized controlled trials should be performed to evaluate the safety and effectiveness of idarucizumab for acute ischemic stroke treatment.

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“…We collected the patients’ clinical data using the local stroke registry, including patients’ demographic data, vascular risk factors, and functional neurological evaluation results. The Latvian version of the National Institutes of Health Stroke Scale (NIHSS-LV) was used to evaluate patients’ neurological outcomes at discharge, and the modified Rankin scale (mRS) was used for assessing the functional outcome [ 10 , 11 , 12 ]. The trial of ORG 10172 in acute stroke treatment (TOAST) classification was used for the determination of stroke etiology [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of Anticoagulants in Reducing Mortality and Disability in Cardioembolic Stroke Patients

et al. 2022

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Background and Objectives: Stroke is currently the second most common cause of death and disability-adjusted life years worldwide. Previous studies have determined that cardioembolic stroke is associated with higher mortality. Our aim is to compare the long-term outcome and mortality of atherothrombotic, cardioembolic stroke patients and patients taking direct oral anticoagulants (DOACs), and to demonstrate that adequate treatment with DOACs is associated with better results. Materials and Methods: In our retrospective study, we collected the data of ischemic stroke patients who were treated at P. Stradins Clinical University Hospital, Riga, Latvia, Stroke Unit, in the year 2017. In the present study, we analyzed this information to assess the patients’ demographic and clinical data, vascular risk factors, functional and neurological evaluation results, and the use of anticoagulant therapy. Stroke survivors were followed-up via telephone at 30/90/180/365 days and 4 years after being discharged from the hospital. The Latvian version of the National Institutes of Health Stroke Scale (NIHSS-LV) was used to evaluate patients’ neurological outcomes at discharge, and patients’ functional outcomes were evaluated using the modified Rankin scale (mRS). The collected data of the patients were separated into three groups according to the stroke subtype and use of direct oral anticoagulants. Results: A total of 654 ischemic stroke patients were admitted to the hospital in the year 2017. Of all the strokes included in the study, 262 presented an atherothrombotic etiology and 392 presented a cardioembolic etiology. The median age of the patients in the study was 76 years (IQR: 67–83). The median age of patients in the atherothrombotic stroke group was 71 years (IQR = 64–79), in the cardioembolic stroke group it was 79 (IQR = 72–84), and in the DOAC group it was 75 years (IQR = 69–82), respectively. At the period of four years, of all the atherothrombotic stroke survivors 14 (10.5%) had a severe disability, and 64 (48.1%) did not survive. However, 12 (4.1%) of the cardioembolic stroke survivors were severely disabled and 37 (12.5%) had died. In the group of patients taking DOACs 6 (4.5%) had a severe disability and 17 (12.9%) did not survive. In all the patient groups, the leading cause of death was due to severe disability (22%), followed by recurrent cardioembolic events (8%). Conclusions: Previous studies until now have concluded that cardioembolic stroke is associated with higher mortality and an unfavorable functional outcome. In our study, the cardioembolic stroke group and the DOAC group had a statistically significant higher percentage of patients with congestive heart failure and older age, but their long-term mortality was lower and they achieved independence more often than the atherothrombotic stroke patients. The proper use of anticoagulants shows great improvement in long-term survival rate and functional outcome.

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The adaption and evaluation of a Latvian version of the National Institutes of Health Stroke Scale

Cited by 6 publications

References 13 publications

Validation of a Polish version of the National Institutes of Health Stroke Scale: Do moderate psychometric properties affect its clinical utility?

Validation of a Polish version of the National Institutes of Health Stroke Scale: Do moderate psychometric properties affect its clinical utility?

Idarucizumab in Dabigatran-Treated Patients with Acute Ischemic Stroke Receiving Thrombolytic Therapy

Impact of Anticoagulants in Reducing Mortality and Disability in Cardioembolic Stroke Patients

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