NIHSS-time score easily predicts outcomes in rt-PA patients: The SAMURAI rt-PA registry

被引：40

作者：

Aoki, Junya ^{[1
]}

Kimura, Kazumi ^{[1
]}

Koga, Masatoshi ^{[2
]}

Kario, Kazuomi ^{[3
]}

Nakagawara, Jyoji ^{[4
,5
]}

Furui, Eisuke ^{[6
]}

Shiokawa, Yoshiaki ^{[7
,8
]}

Hasegawa, Yasuhiro ^{[9
]}

Okuda, Satoshi ^{[10
]}

Yamagami, Hiroshi ^{[11
]}

Okada, Yasushi ^{[12
,13
]}

Shibazaki, Kensaku ^{[1
]}

Sakamoto, Yuki ^{[1
]}

Toyoda, Kazunori ^{[14
]}

机构：

[1] Kawasaki Med Sch, Dept Stroke Med, Kurashiki, Okayama 7010192, Japan

[2] Natl Cerebral & Cardiovasc Ctr, Div Stroke Care Unit, Suita, Osaka, Japan

[3] Jichi Med Univ, Sch Med, Dept Med, Div Cardiovasc Med, Shimotsuke, Japan

[4] Nakamura Mem Hosp, Dept Neurosurg, Sapporo, Hokkaido, Japan

[5] Nakamura Mem Hosp, Stroke Ctr, Sapporo, Hokkaido, Japan

[6] Kohnan Hosp, Dept Stroke Neurol, Sendai, Miyagi, Japan

[7] Kyorin Univ, Sch Med, Dept Neurosurg, Mitaka, Tokyo 181, Japan

[8] Kyorin Univ, Sch Med, Stroke Ctr, Mitaka, Tokyo 181, Japan

[9] St Marianna Univ, Sch Med, Dept Neurol, Kawasaki, Kanagawa, Japan

[10] Natl Hosp Org, Nagoya Med Ctr, Dept Neurol, Nagoya, Aichi, Japan

[11] Kobe City Med Ctr Gen Hosp, Stroke Ctr, Kobe, Hyogo, Japan

[12] Natl Hosp Org, Kyushu Med Ctr, Dept Cerebrovasc Med, Fukuoka, Japan

[13] Natl Hosp Org, Kyushu Med Ctr, Clin Res Inst, Fukuoka, Japan

[14] Natl Cerebral & Cardiovasc Ctr, Dept Cerebrovasc Med, Suita, Osaka, Japan

来源：

JOURNAL OF THE NEUROLOGICAL SCIENCES | 2013年 / 327卷 / 1-2期

关键词：

Acute stroke; Thrombolysis; NIHSS score; Onset to treatment time; TISSUE-PLASMINOGEN-ACTIVATOR; ACUTE ISCHEMIC-STROKE; EARLY RECANALIZATION; POOLED ANALYSIS; T-PA; THROMBOLYSIS; ALTEPLASE; NINDS;

D O I：

10.1016/j.jns.2013.01.029

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

Background: We aimed to devise a scale comprising a simple multiplication of initial National Institutes of Health Stroke Scale (NIHSS) score and onset-to-treatment time (OTT) as a scale for predicting outcomes after recombinant tissue plasminogen activator (rt-PA) therapy. Methods: Data from rt-PA patients in 10 stroke centers in Japan were investigated. NIHSS-time score was calculated as initial NIHSS score x OTT. Results: Subjects comprised 526 patients. Median NIHSS score was 12 (7-18), and median OTT was 2.42 h (2.00-2.75 h). Median NIHSS-time score was 27.7 (16.9-41.7). Good (modified Rankin Scale [mRS] 0-1) and poor (mRS 4-6) outcome rates at 3 months for patients with NIHSS-time scores <= 10 were 71.1% and 7.8%, compared to 54.7% and 16.5% for scores >10 and <= 20, 38.9% and 31.9% for scores >20 and <= 30, 25.0% and 44.6% for scores >30 and and <= 40, and 17.4% and 61.8% for scores >40, respectively. Cut-off NIHSS-time scores to predict good and poor outcomes with 50% probability were defined as 20 and 40, respectively. Multivariate logistic regression analysis revealed NIHSS-time score as an independent predictor of good (odds ratio [OR], 0.587; 95% confidence interval [CI], 0.422-0.818, p = 0.002) and poor (OR, 1.756; 95%CI, 1.227-2.514, p = 0.002) outcomes after adjusting for age, sex, NIHSS score, OTT, Alberta Stroke Program Early CT Score, internal carotid artery occlusion, and glucose level. Conclusions: NIHSS-time score predicts clinical outcomes in rt-PA patients. (c) 2013 Elsevier B.V. All rights reserved.

引用

页码：6 / 11

页数：6

共 29 条

[1]

CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].

ADAMS, HP ;

BENDIXEN, BH ;

KAPPELLE, LJ ;

BILLER, J ;

LOVE, BB ;

GORDON, DL ;

MARSH, EE ;

KASE, CS ;

WOLF, PA ;

BABIKIAN, VL ;

LICATAGEHR, EE ;

ALLEN, N ;

BRASS, LM ;

FAYAD, PB ;

PAVALKIS, FJ ;

WEINBERGER, JM ;

TUHRIM, S ;

RUDOLPH, SH ;

HOROWITZ, DR ;

BITTON, A ;

MOHR, JP ;

SACCO, RL ;

CLAVIJO, M ;

ROSENBAUM, DM ;

SPARR, SA ;

KATZ, P ;

KLONOWSKI, E ;

CULEBRAS, A ;

CAREY, G ;

MARTIR, NI ;

FICARRA, C ;

HOGAN, EL ;

CARTER, T ;

GURECKI, P ;

MUNTZ, BK ;

RAMIREZLASSEPAS, M ;

TULLOCH, JW ;

QUINONES, MR ;

MENDEZ, M ;

ZHANG, SM ;

ALA, T ;

JOHNSTON, KC ;

ANDERSON, DC ;

TARREL, RM ;

NANCE, MA ;

BUDLIE, SR ;

DIERICH, M ;

HELGASON, CM ;

HIER, DB ;

SHAPIRO, RA .

STROKE, 1993, 24 (01) :35-41

[2]

Effects of admission hyperglycemia on stroke outcome in reperfused tissue plasminogen activator-treated patients [J].

Alvarez-Sabín, J ;

Molina, CA ;

Montaner, J ;

Arenillas, JF ;

Huertas, R ;

Ribo, M ;

Codina, A ;

Quintana, M .

STROKE, 2003, 34 (05) :1235-1240

[3]

Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy [J].

Barber, PA ;

Demchuk, AM ;

Zhang, JJ ;

Buchan, AM .

LANCET, 2000, 355 (9216) :1670-1674

[4]

Barsan WG, 1993, CEREBROVASC DIS, V153, P2558

[5]

The penumbra system: A mechanical device for the treatment of acute stroke due to thromboembolism [J].

Bose, A. ;

Henkes, H. ;

Alfke, K. ;

Reith, W. ;

Mayer, T. E. ;

Berlis, A. ;

Branca, V. ;

Sit, S. Po .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2008, 29 (07) :1409-1413

[6]

Intracerebral hemorrhage after intravenous t-PA therapy for ischemic stroke [J].

Brott, T ;

Broderick, J ;

Kothari, R ;

ODonoghue, M ;

Barsan, W ;

Tomsick, T ;

Spilker, J ;

Miller, R ;

Sauerbeck, L ;

Farrell, J ;

Kelly, J ;

Perkins, T ;

Miller, R ;

McDonald, T ;

Rorick, M ;

Hickey, C ;

Armitage, J ;

Perry, C ;

Thalinger, K ;

Rhude, R ;

Schill, J ;

Becker, PS ;

Heath, RS ;

Adams, D ;

Reed, R ;

Klei, M ;

Hughes, A ;

Anthony, J ;

Baudendistel, D ;

Zadicoff, C ;

Rymer, M ;

Bettinger, I ;

Laubinger, P ;

Schmerler, M ;

Meiros, G ;

Lyden, P ;

Dunford, J ;

Zivin, J ;

Rapp, K ;

Babcock, T ;

Daum, P ;

Persona, D ;

Brody, M ;

Jackson, C ;

Lewis, S ;

Liss, J ;

Mahdavi, Z ;

Rothrock, J ;

Tom, T ;

Zweifler, R .

STROKE, 1997, 28 (11) :2109-2118

[7]

Progression in acute stroke - Value of the initial NIH Stroke Scale score on patient stratification in future trials [J].

DeGraba, TJ ;

Hallenbeck, JM ;

Pettigrew, KD ;

Dutka, AJ ;

Kelly, BJ .

STROKE, 1999, 30 (06) :1208-1212

[8]

RECOMBINANT TISSUE PLASMINOGEN-ACTIVATOR IN ACUTE THROMBOTIC AND EMBOLIC STROKE [J].

DELZOPPO, GJ ;

POECK, K ;

PESSIN, MS ;

WOLPERT, SM ;

FURLAN, AJ ;

FERBERT, A ;

ALBERTS, MJ ;

ZIVIN, JA ;

WECHSLER, L ;

BUSSE, O ;

GREENLEE, R ;

BRASS, L ;

MOHR, JP ;

FELDMANN, E ;

HACKE, W ;

KASE, CS ;

BILLER, J ;

GRESS, D ;

OTIS, SM .

ANNALS OF NEUROLOGY, 1992, 32 (01) :78-86

[9]

Predictors of in-hospital mortality in patients with acute ischemic stroke treated with thrombolytic therapy [J].

Heuschmann, PU ;

Kolominsky-Rabas, PL ;

Roether, J ;

Misselwitz, B ;

Lowitzsch, K ;

Heidrich, J ;

Hermanek, P ;

Leffmann, C ;

Sitzer, M ;

Biegler, M ;

Buecker-Nott, HJ ;

Berger, K .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (15) :1831-1838

[10]

Iguchi Y, 2011, STROKE, V31, P51

← 1 2 3 →