Table of Contents
ISRN Neurology
Volume 2011, Article ID 354642, 9 pages
http://dx.doi.org/10.5402/2011/354642
Research Article

Predicting Acute Ischaemic Stroke Outcome Using Clinical and Temporal Thresholds

1Department of Neurology, Saint Jean Hospital, 20 Avenue du Languedoc, 66046 Perpignan Cedex, France
2Department of Neurology, CHU Hassan II, Dhar Mehraz, Fes 30000, Morocco
3Department of Neurology, CHU Besancon, 3 Boulevard Fleming, 25030 Besancon Cedex, France

Received 11 April 2011; Accepted 14 May 2011

Academic Editor: G. de Courten-Myers

Copyright © 2011 Denis Sablot et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Few studies have analysed the natural course of cerebral ischaemia for predicting outcome. We aimed to determine the early clinical findings and the thresholds for deficit severity and symptom duration that make it possible to stratify outcome. Methods. We included 154 patients with transient ischaemic attack or ischaemic stroke. Stroke profiles and neurological status were assessed from onset to 24 hrs, on admission, at 48 hrs, and at discharge. Outcomes were evaluated using the modified Rankin Scale. Positive and negative predictive values were calculated for the different thresholds. The model was subsequently evaluated on a new prospective cohort of 157 patients. Results. Initial National Institute of Health Stroke Scale (NIHSS) score <5 and symptoms regressing within 135 min were predictive of good outcome. Initial NIHSS score >22 and symptom stability after 1,230 min were predictive of physical dependency or death. Conclusions. Low and high NIHSS cut-off points are effective positive predictive values for good and poor outcomes. Thresholds for symptom duration are less conclusive.