De Raedt S, Brouns R, De Smedt A, Aries M J H, Uyttenboogaart M, Luijckx G J, De Keyser J
Department of Neurology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium.
Clin Neurol Neurosurg. 2013 Jun;115(6):729-31. doi: 10.1016/j.clineuro.2012.08.026. Epub 2012 Sep 8.
Stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS) is a strong predictor of functional outcome. A short version, the sNIHSS-5, scoring only strength in right and left leg, gaze, visual fields and language, was developed for use in the prehospital setting. Because scoring both legs in anterior circulation strokes is not contributive, we assessed the value of a 4-item score (the sNIHSS-4), omitting the item 'strength in the unaffected leg', in predicting stroke outcome.
The study population consisted of anterior circulation ischemic stroke patients who participated in the LUB-INT-9 trial. We included all patients in whom the following data were available: NIHSS within 6h after stroke onset and daily between days 2 and 5, and the 12-week modified Rankin Scale (mRS) score. Poor outcome was defined as a mRS score>3.
There was an excellent correlation between the NIHSS and sNIHSS-4 at all time points for both left and right-sided strokes. Scores at day 2 were a good predictor of poor outcome. Cutoff scores for NIHSS and sNIHSS-4 at day 2 were 15 and 5 in left hemispheric strokes, and 12 and 4 in right hemispheric strokes.
The sNIHSS-4 is as good as the NIHSS at predicting stroke outcome in both right and left anterior circulation strokes.
美国国立卫生研究院卒中量表（NIHSS）所测量的卒中严重程度是功能预后的有力预测指标。为用于院前环境，开发了一个简短版本，即sNIHSS - 5，仅对左右腿力量、凝视、视野和语言进行评分。由于在前循环卒中中对双腿进行评分并无助益，我们评估了一个4项评分（sNIHSS - 4）在预测卒中预后方面的价值，该评分省略了“患侧腿力量”这一项。
研究人群包括参与LUB - INT - 9试验的前循环缺血性卒中患者。我们纳入了所有具备以下数据的患者：卒中发作后6小时内以及第2天至第5天每日的NIHSS评分，以及12周改良Rankin量表（mRS）评分。预后不良定义为mRS评分>3。
对于左侧和右侧卒中，在所有时间点NIHSS与sNIHSS - 4之间均存在极佳的相关性。第2天的评分是预后不良的良好预测指标。在左侧半球卒中中，第2天NIHSS和sNIHSS - 4的截断值分别为15和5；在右侧半球卒中中，截断值分别为12和4。
在预测左右前循环卒中的预后方面，sNIHSS - 4与NIHSS同样出色。
