The following is a summary of “National Institutes of Health Stroke Scale is comparable to the ICH score in predicting outcomes in spontaneous acute intracerebral hemorrhage,” published in the July 2024 issue of Neurology by Kazaryan et al.
Researchers conducted a retrospective study to evaluate the National Institutes of Health NIH Stroke Scale (NIHSS) to assess deficit severity and prognosis in patients with intracerebral hemorrhage (ICH). The study aimed to unify assessment for ICH and acute ischemic stroke (AIS), facilitate the clinical use of a more straightforward prognostic tool, and enhance ICH care quality monitoring in administrative datasets.
They examined the relationship between NIHSS scores shortly after arrival in the Emergency Department and outcomes at 3 months (modified Rankin Scale, mRS 3–6) and case fatality among randomized trial patients with ICH. NIHSS’s ability to predict outcomes was compared to the ICH score, a standard prognostic scale for ICH.
The results showed that among 384 patients, the average age was 65 years (±13), with males comprising 66%. The NIHSS score had a median of 16 (IQR 9–25), the initial hematoma volume averaged 29 mL (±38), and the ICH score median was 1 (IQR 0–2). At 3 months, the mRS median was 4 (IQR 2–6), with 70% experiencing dependency or death and 26% case fatality. The NIHSS and ICH scores correlated strongly (r = 0.73), each showing a strong correlation with 90-day mRS (NIHSS, r = 0.61; ICH score, r = 0.62). NIHSS performed similarly to the ICH score in predicting dependency or death (c = 0.80 vs. 0.80, P=0.83) and case fatality (c = 0.78 vs. 0.80, P=0.29). NIHSS accurately predicted dependency or death at 74.1% (NIHSS 17.5) and case fatality at 75.0% (NIHSS 18.5) thresholds.
Investigators found that the NIHSS performed as well as the ICH Score in predicting 3-month outcomes in patients with ICH, and its widespread use in clinical settings makes it a valuable tool for prognosis, treatment development, and adjusting for case complexity in ICH.
Source: frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1401793/full
