EARLY PREDICTION OF OUTCOME AFTER ACUTE ISCHEMIC STROKE WITH STROKE SCALE SCORE
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 34
Abstract
BACKGROUND Stroke is a leading cause of death after cardiac diseases and cancers. It is also a major cause of morbidity and mortality around the world. Patients of stroke with initial similar clinical deficits can improve dramatically or worsen during the first 48 to 72 hours. It is often not clear for some days after stroke as to how patients are likely to fare as various ongoing pathophysiologic processes affect the final functional outcome of the patient. The need for early and accurate outcome assessment is of paramount relevance in the current climate of financial constraint. Therapies will need to be administered within the first few hours after stroke. That decision based upon the relative risks and benefits of treatment could be aided by knowing the likely outlook of the patient. Stroke can be a devastating illness causing a lot of distress to the patients and their families, so the personal and social consequences of any residual disability after stroke can be considerable. Early prediction of stroke outcome might be improved by developing clinical criteria. MATERIALS AND METHODS This study was designed to evaluate the clinical scale NIHSS that would help early prediction of stroke recovery as accurate assessment of prognosis in the first hours of stroke is desirable for best patient management. The study was conducted in Government General Hospital, Kakinada over a period of 2 years from October 2014 to October 2016. Fifty patients fulfilling the selection criteria were included in this study. RESULTS Among enrolled patients, 36 (72%) were males and 14 (28%) were females with ages ranging from 45 years to 70 years and median age of 55.46 years. Thirty patients (60%) had left sided ischemic injury in territory of anterior cerebral circulation and twenty patients (40%) had right sided ischemic injury. The mean NIHSS score presentation was 19.82 which ranged from 6 to 37. Patient’s functional outcome was measured by using Barthel Index on 7th day with mean value of 22.8 which ranged from 0 to 80. CONCLUSION Baseline NIHSS score strongly predicts the likelihood of a patient’s recovery of the stroke. NIHSS score is a valuable and inexpensive method of predicting the functional outcome in stroke patients after acute event. Early prediction of prognosis and the extent of recovery may help the physician not only counseling the family members but also in planning the management of such patients. NIHSS score and Barthel index are inversely related in predicting the functional out come in acute stroke patients at the end of one week after the stroke.
Authors and Affiliations
Atchin Naidu M
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