This article is more than 5 years old. Information may no longer be current.

NIH Stroke Scale identified high mortality risk in acute ischemic stroke patients

Issue: May 2012

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

For Medicare beneficiaries with acute ischemic stroke, the NIH Stroke Scale provided substantial prognostic information regarding 30-day mortality risk, according to recent study results.

“There has been growing interest in reporting outcomes with stroke, particularly from medical beneficiaries hospitalized with CVD, including acute ischemic stroke,” Gregg C. Fonarow, MD, of the division of cardiology at the University of California, Los Angeles, said during a presentation at the American Heart Association’s Emerging Science Series webinar.

Fonarow said the objectives of the study were to quantify the relation and risk discrimination of the initial NIH Stroke Scale with 30-day mortality rates among Medicare beneficiaries hospitalized with acute ischemic stroke and to identify potential categories of the NIH Stroke Scale that provide optimal discrimination of 30-day mortality risk.

Researchers linked data from the Get With The Guidelines (GWTG)-Stroke registry with enrollment files and inpatient claims from CMS between April 2003 to December 2006. More than 33,700 patients with acute ischemic stroke had documented NIH Stroke Scale, of whom 33,102 (mean age, 79 years; 58% women) were included in the study. Outcome measures included all-cause mortality within 30 days from time of admission.

Overall, 13.6% of patients died within the first 30 days, according to study results. Increasing NIH Stroke Scale score had a strong graded relation to higher 30-day mortality. For patients with an NIH Stroke Scale score of zero, 30-day mortality rate was 2.3% vs. more than 75% for patients with a score of at least 40.

Placing patients into four NIH Stroke Scale categories, researchers found 30-day mortality rates of 4.2% for category zero to seven; 13.9% for eight to 13; 31.6% for 14 to 21; and 53.5% for 22 to 42. Broken into three categories, 30-day mortality rates were 3.6% in zero to five, 11.6% in six to 13 and 39.9% in 14 to 42. Study results showed excellent discrimination provided in a model with NIH Stroke Scale alone whether included as a continuous variable, four categories or three categories.

“In acute ischemic stroke with categorization of the NIH Stroke Scale in three or four groups, patients can be readily identified as being at low, medium or high risk for 30-day mortality, even in the absence of any other clinical variable,” Fonarow said. “These findings highlight the importance of having a valid specific measure of stroke severity, such as the NIH Stroke Scale, as a determinant of mortality after acute ischemic stroke from Medicare beneficiaries.”

For more information:

• Fonarow GC. J Am Heart Assoc. 2012;1:42-50.

Disclosure: Dr. Fonarow is a Get With The Guidelines committee member.

Follow CardiologyToday.com on Twitter.