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Neurology and Therapy

Open Access 01-03-2024 | Stroke | ORIGINAL RESEARCH

The Association Between National Institutes of Health Stroke Scale Score and Clinical Outcome in Patients with Large Core Infarctions Undergoing Endovascular Treatment

Authors: Lingyu Zhang, Jinfu Ma, Mengmeng Wang, Lin Zhang, Wenzhe Sun, Honghong Ji, Chengsong Yue, Jiacheng Huang, Wenjie Zi, Fengli Li, Changwei Guo, Pengfei Wang

Published in: Neurology and Therapy

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Abstract

Introduction

This study aimed to analyze the association between baseline National Institutes of Health Stroke Scale (NIHSS) scores and clinical outcomes in patients with large core infarctions undergoing endovascular treatment (EVT), a relationship that remains unclear.

Methods

Data were obtained from the MAGIC study, a prospective multicenter cohort study focusing on patients with acute large core ischemic stroke. This analysis evaluated the impact of NIHSS scores on EVT outcomes in patients with large core infarctions. Primary outcome metrics included favorable outcomes (modified Rankin Scale [mRS] of 0–3 at 90 days), while secondary outcomes encompassed shifts in mRS scores, functional independence (mRS score of 0–2), mRS score of 0–4, and successful recanalization rates. Adverse events considered were symptomatic intracranial hemorrhage (sICH) and mortality.

Results

A total of 490 patients were enrolled in this study. Higher baseline NIHSS scores were inversely correlated with favorable outcomes (adjusted odds ratio [OR] in model 3, 0.848 [0.797–0.903], P < 0.001), particularly in patients with NIHSS scores above 20 (adjusted OR in model 3, 0.518 [0.306–0.878] vs. 0.290 [0.161–0.523]). Regarding adverse events, higher baseline NIHSS scores significantly correlated with increased 90-day mortality rates (adjusted OR in model 3, 1.129 [1.072–1.189], P < 0.001). This correlation became insignificant when baseline NIHSS scores exceeded 22. Additionally, baseline NIHSS scores partially mediated the association between age (indirect effect = − 0.0005, 19.39% mediated) and sex (indirect effect = 0.0457, 25.08% mediated) with the primary outcome.

Conclusions

The findings indicate that higher baseline NIHSS scores correlate with poorer outcomes and increased mortality, particularly when scores exceed 20. Moreover, age and sex indirectly influence favorable outcomes through their association with baseline NIHSS scores.
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Metadata
Title
The Association Between National Institutes of Health Stroke Scale Score and Clinical Outcome in Patients with Large Core Infarctions Undergoing Endovascular Treatment
Authors
Lingyu Zhang
Jinfu Ma
Mengmeng Wang
Lin Zhang
Wenzhe Sun
Honghong Ji
Chengsong Yue
Jiacheng Huang
Wenjie Zi
Fengli Li
Changwei Guo
Pengfei Wang
Publication date
01-03-2024
Publisher
Springer Healthcare
Keyword
Stroke
Published in
Neurology and Therapy
Print ISSN: 2193-8253
Electronic ISSN: 2193-6536
DOI
https://doi.org/10.1007/s40120-024-00588-8