TY - JOUR
T1 - Recovery after ischemic stroke
T2 - Criteria for good outcome by level of disability at day 7
AU - Hallevi, Hen
AU - Albright, Karen C.
AU - Martin-Schild, Sheryl B.
AU - Barreto, Andrew D.
AU - Morales, Miriam M.
AU - Bornstein, Natan
AU - Ifejika, Nneka L.
AU - Shuaib, Ashfaq
AU - Grotta, James C.
AU - Savitz, Sean I.
PY - 2009/9/1
Y1 - 2009/9/1
N2 - Background: Ischemic stroke is a leading cause of morbidity. Assessing the chances of recovery is critical to optimize poststroke care. Methods: We used a cohort of patients from the Virtual International Stroke Trial Archive that participated in acute stroke trials (control arm) and were followed for 90 days. The cohort was grouped by day 7 (D7) modified Rankin scale (mRS) scores. Variables that were associated with good outcome (mRS 0-2 at 90 days) in the univariate analysis were entered into a logistic regression model to determine the independent good outcome criteria for each D7 mRS tier. Results: We analyzed 1,798 patients. The independent good outcome criteria identified for different mRS tiers were: D7 mRS of 3: age ≤70, 0-2 vascular risk factors, D7 NIH Stroke Scale (NIHSS) arm strength ≤1, D7 NIHSS language score = 0; D7 mRS of 4: age ≤70, male, D7 NIHSS facial palsy ≤1, D7 NIHSS visual = 0, D7 NIHSS leg strength ≤1, D7 NIHSS dysarthria = 0; D7 mRS of 5: age ≤70, IV tPA treatment, D7 NIHSS dysarthria = 0, D7 NIHSS leg strength ≤2. For each mRS tier, we observed a graded increase in the percentage of the primary and secondary end points with increase in the number of criteria. Conclusions: We identified clinical variables that predict good outcome, are specific to each day 7 mRS tier, and enable easy and informative assessment of the patient's likelihood of achieving varying degrees of recovery at day 90. These results may be useful in both clinical practice and research but require validation in an independent patient cohort.
AB - Background: Ischemic stroke is a leading cause of morbidity. Assessing the chances of recovery is critical to optimize poststroke care. Methods: We used a cohort of patients from the Virtual International Stroke Trial Archive that participated in acute stroke trials (control arm) and were followed for 90 days. The cohort was grouped by day 7 (D7) modified Rankin scale (mRS) scores. Variables that were associated with good outcome (mRS 0-2 at 90 days) in the univariate analysis were entered into a logistic regression model to determine the independent good outcome criteria for each D7 mRS tier. Results: We analyzed 1,798 patients. The independent good outcome criteria identified for different mRS tiers were: D7 mRS of 3: age ≤70, 0-2 vascular risk factors, D7 NIH Stroke Scale (NIHSS) arm strength ≤1, D7 NIHSS language score = 0; D7 mRS of 4: age ≤70, male, D7 NIHSS facial palsy ≤1, D7 NIHSS visual = 0, D7 NIHSS leg strength ≤1, D7 NIHSS dysarthria = 0; D7 mRS of 5: age ≤70, IV tPA treatment, D7 NIHSS dysarthria = 0, D7 NIHSS leg strength ≤2. For each mRS tier, we observed a graded increase in the percentage of the primary and secondary end points with increase in the number of criteria. Conclusions: We identified clinical variables that predict good outcome, are specific to each day 7 mRS tier, and enable easy and informative assessment of the patient's likelihood of achieving varying degrees of recovery at day 90. These results may be useful in both clinical practice and research but require validation in an independent patient cohort.
KW - Level of disability, stroke
KW - Outcome, stroke
KW - Recovery after ischemic stroke
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U2 - 10.1159/000229552
DO - 10.1159/000229552
M3 - Article
C2 - 19628935
AN - SCOPUS:67651006009
SN - 1015-9770
VL - 28
SP - 341
EP - 348
JO - Cerebrovascular Diseases
JF - Cerebrovascular Diseases
IS - 4
ER -