Time-dependence of NIHSS in predicting functional outcome of patients with acute ischemic stroke treated with intravenous thrombolysis

Wu, Zimu; Zeng, Minyan; Li, Chao; Qiu, Hongyan; Feng, Haixia; Xu, Xiaoyue; Zhang, Haoyang; Wu, Jun

doi:10.1136/postgradmedj-2019-136398

Cited by 28 publications

(32 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In another study, significant, male gender and NIHSS were the significant predictors of functional outcome at 3 months (10) . Similar conclusions were reported by the studies of Bhaskar et al (11) Wu et al (12) Thatikonda et al (13) . Of note, the Egyptian study of Mohamed et al (14) , older age, presence of diabetes and dyslipidemia was significant predictors of poor outcome reported in 50.0 % of patients in that 157 patients study.…”

Section: Discussionsupporting

confidence: 90%

Predictors of Functional Outcome After Treatment of Acute Ischemic Stroke

Abdel-Monem

Afifi

Essmat

2020

Suez Canal University Medical Journal

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 90%

Predictors of Functional Outcome After Treatment of Acute Ischemic Stroke

Abdel-Monem

Afifi

Essmat

2020

Suez Canal University Medical Journal

View full text Add to dashboard Cite

“…The level of the NIHSS score can reflect the clinical situation of the patient with ACI more intuitively. The NIHSS score reveals the extent of neurological damage and is usually used to evaluate the efficacy of patients with ACI after therapy ( Wu et al., 2019 ). In this study, twenty-two studies with 2020 patients were assessed using the NIHSS score.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Xueshuantong Injection on Acute Cerebral Infarction: Clinical Evidence and GRADE Assessment

et al. 2020

View full text Add to dashboard Cite

Introduction Xueshuantong injection (XST), a Chinese Medicine, is clinically effective in treating acute cerebral infarction (ACI). However, the meta-analysis of XST combined with conventional treatments (CTs) on ACI remain unexplored. The purpose of this study is to investigate the efficacy and safety of XST combined with CTs on patients with ACI. Methods Randomized controlled trials (RCTs) were screened from the Cochrane Library, PubMed, Web of Science, EMBASE, and four Chinese medical databases. The meta-analysis was performed using RevMan 5.3 and STATA 16.0. The GRADE assessment was performed by the GRADEprofiler (GRADEpro version: 3.6). The aggregate 95% confidence intervals ( CI s) and relative risk ( RR ) estimates were calculated. Results Forty studies were included, involving a total of 3,868 patients. XST combined with CTs performed significantly better than CTs alone on the overall response rate (ORR) after treatment ( RR = 1.21, 95% CI = 1.17−1.25, P < 0.001). There was no statistical differences in the incidence of adverse reactions between the experimental group (XST plus CTs) and control group (CTs alone). Groups treated with XST substantially decreased the National Institutes of Health Stroke Scale (NIHSS) score compared to the groups without XST ( WMD = −5.31, 95% CI = −6.40 to −4.22, P < 0.001). Activities of daily living (ADL) scores were significantly better in the group treated with XST than CTs alone ( WMD = 12.51, 95% CI = 5.6−19.38, P < 0.001). Patients who received XST combined with CTs showed significantly higher improvements in high-sensitivity C-reactive protein (hs-CRP) ( WMD = −2.47, 95% CI = −3.11 to −1.82, P < 0.001) and interleukin 6 (IL-6) ( WMD = −13.66, 95% CI = −17.80 to −9.51, P < 0.001) than those who received CTs alone. The GRADE assessment indicates that the comprehensive quality of this evidence is low. Conclusions This meta-analysis and GRADE assessment conditionally recommend that XST combined with CTs can increase the overall response rate, ameliorate neurological deficit, and improve activities of daily living function more than CTs alone. A significant reduction in the hs-CRP and IL-6 levels were observed when XST was combined with CTs.

show abstract

“…Previous studies have predicted the outcome of AIS patients using only one or two factors, particularly the NIHSS score and age, which have been recognized as the most direct contributors to patient outcome (20). The NIHSS score indicates the degree of neurological function damage and is frequently used to determine the severity of the patient's condition on admission (21). The majority of studies have used the NIHSS score as an important predictive factor for patient outcome following AIS; however, the outcome threshold frequently differed among these studies (21).…”

Section: Discussionmentioning

confidence: 99%

“…The NIHSS score indicates the degree of neurological function damage and is frequently used to determine the severity of the patient's condition on admission (21). The majority of studies have used the NIHSS score as an important predictive factor for patient outcome following AIS; however, the outcome threshold frequently differed among these studies (21). The present study also indicated that the NIHSS score on admission was the strongest factor associated with patient outcome, which was consistent with the conclusions of previous studies.…”

Section: Discussionmentioning

confidence: 99%

Outcome prediction for patients with anterior circulation acute ischemic stroke following endovascular treatment: A single‑center study

Liu

Zhou

et al. 2019

Exp Ther Med

View full text Add to dashboard Cite

Previous studies have identified various factors associated with the outcomes of acute ischemic stroke (AIS) but considered only 1 or 2 predictive factors. The present study aimed to use outcome-related factors derived from biochemical, imaging and clinical data to establish a logistic regression model that can predict the outcome of patients with AIS following endovascular treatment (EVT). The data of 118 patients with anterior circulation AIS (ACAIS) who underwent EVT between October 2014 and August 2018 were retrospectively analyzed. The patients were divided into 2 groups based on the modified Rankin Scale score at three months after surgery, where 0–2 points were considered to indicate a favorable outcome and 3–6 points were considered a poor outcome. Non-conditional logistic stepwise regression was used to identify independent variables that were significantly associated with patient outcome, which were subsequently used to establish a predictive statistical model, receiver operating characteristic (ROC) curve was used to show the performance of statistical model and analyze the specific association between each factor and outcome. Among the 118 patients, 47 (39.83%) exhibited a good and 71 (60.17%) exhibited a poor outcome. Multivariate analysis revealed that the predictive model was statistically significant (χ2=78.92; P<0.001), and that the predictive accuracy of the model was 83.1%, which was higher compared with that obtained using only a single factor. ROC curve analysis shows the area under curve of the statistical model was 0.823, the analysis of diagnostic threshold for prognostic factors indicated that age, diffusion-weighted imaging lesion volume, glucose on admission, National Institutes of Health Stroke Scale score on admission and hypersensitive C-reactive protein were valuable predictive factors for the outcome of EVT (P<0.05). In conclusion, a predictive model based on non-conditional logistic stepwise regression analysis was able to predict the outcome of EVT for patients with ACAIS.

show abstract

Time-dependence of NIHSS in predicting functional outcome of patients with acute ischemic stroke treated with intravenous thrombolysis

Cited by 28 publications

References 31 publications

Predictors of Functional Outcome After Treatment of Acute Ischemic Stroke

Predictors of Functional Outcome After Treatment of Acute Ischemic Stroke

Efficacy and Safety of Xueshuantong Injection on Acute Cerebral Infarction: Clinical Evidence and GRADE Assessment

Outcome prediction for patients with anterior circulation acute ischemic stroke following endovascular treatment: A single‑center study

Contact Info

Product

Resources

About