Predicting outcomes after transient ischemic attack and stroke.

PURPOSE OF REVIEW

Predicting functional outcome and mortality after stroke, with or without thrombolysis, is a critical role of neurologists. This article reviews the predictors of outcome after ischemic stroke.

RECENT FINDINGS

Several scores were recently designed to predict (1) mortality and poor functional outcome after ischemic stroke, (2) the functional outcome and risk of symptomatic intracranial hemorrhage (sICH) after thrombolysis, and (3) the risk of stroke following TIA. Validation of these prediction instruments is ongoing, and studies will be critical to determine the general applicability of these scores.

SUMMARY

Although several scores were developed to predict mortality and outcome after stroke, it may be premature to employ these prediction scores to determine individual patient outcome. Similarly, prediction scores should not be used to deny patients tissue plasminogen activator (tPA), even if the scores predict that the patient has a high likelihood of sICH or poor outcome after thrombolysis.