Is the National Institute of Health Stroke Scale a valid prognosticator of the aftermath in patients with ischemic stroke?

Abstract

Cerebrovascular disease is the second most common cause of death in people more than 60 years of age. Predicting the outcome of the stroke is a great challenge for physicians. Various risk factors such as age, sex, co-morbidities, smoking and alcohol habits, type of stroke, National Institute of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS), and others play the role in the outcome of stoke. To assess the degree of impact of NIHSS score in comparison to the other traditional risk factors on the functional outcome and 30-day mortality by mRS in the patients with acute ischemic stroke. Patients with acute ischemic stroke and age more than 18 years were included. Their admission NIHSS score and the 30-day mRS were analyzed. Patients were divided into two groups as survivors and non-survivors. The mean age of survivors and non-survivors was 59.77 ± 10.99 and 65.58 ± 6.67 years, respectively. The NIHSS score on day 1 for non-survivors was 21.21 ± 8.21, and almost half of this score was seen in survivors. The NIHSS score on day 1 had a significant association with mortality with a relative risk of 0.79 (95% CI = 0.70-0.89). The NIHSS score has 73.7% sensitivity and 74.1% specificity with cutoff value of 15.5 for discriminating the outcome of ischemic stroke. The NIHSS and mRS scales are simple, validated, easily applicable, and reliable tools for assessing the mortality and the functional outcome of ischemic stroke patients.