D'Olhaberriague L, Litvan I, Mitsias P, Mansbach H H
Department of Neurology, Henry Ford Hospital and Health Sciences Center, Detroit, Mich 48202, USA.
Stroke. 1996 Dec;27(12):2331-6. doi: 10.1161/01.str.27.12.2331.
The emergence of prophylactic and therapeutic interventions in stroke has been accompanied by the widespread use of stroke classifications and scales that measure deficit (stroke scales) or resulting long-term handicap (handicap and disability scales). Although the accuracy of some scales and classifications has been studied, there is no updated systematic review appraising all of them.
We reviewed the literature and selected 21 studies on classifications and scales. The International Classification of Diseases, 10th revision, achieved the highest interobserver agreement among seven stroke classifications. The National Institutes of Health Stroke Scale, the Canadian Neurological Scale, and the European Stroke Scale had the highest reliability across items among nine stroke scales. The Barthel Index was the most reliable disability scale.
The identification of the most reliable stroke classifications and scales should encourage their use in selection of homogeneous populations of patients for clinical research studies and to improve communication among scientists. Further research is needed to investigate neglected aspects of the neurological examination and the validity of stroke classifications.
在卒中预防和治疗干预措施出现的同时，广泛使用了测量缺损（卒中量表）或由此导致的长期残疾（残疾和失能量表）的卒中分类和量表。尽管已对一些量表和分类的准确性进行了研究，但尚无对所有这些量表和分类进行评估的最新系统评价。
我们检索了文献，并选取了21项关于分类和量表的研究。国际疾病分类第10版在七种卒中分类中观察者间一致性最高。美国国立卫生研究院卒中量表、加拿大神经量表和欧洲卒中量表在九种卒中量表中各项目的可靠性最高。巴氏指数是最可靠的失能量表。
确定最可靠的卒中分类和量表应鼓励在为临床研究选择同质患者群体时使用这些分类和量表，并改善科学家之间的交流。需要进一步研究以调查神经学检查中被忽视的方面以及卒中分类的有效性。
