Abstract
Background: We investigated a method for assessing early improvement and predictive factors of early and late outcomes in patients receiving thrombolytic therapy. Methods: A total of 160 consecutive patients who received thrombolytic therapy were included in the study. Using National Institutes of Health Stroke Scale (NIHSS) scores, percent improvement [(baseline NIHSS score - 24-hour NIHSS score) / baseline NIHSS score × 100] was calculated and compared with delta (baseline NIHSS score - 24-hour NIHSS score) and with major neurological improvement (MNI, NIHSS score of 0-1 or ≥ 8 point improvement at 24 h) by receiver operating characteristic (ROC) curve analysis. Finally, we investigated the independent predictors of improvement at 24 h after the thrombolytic therapy and of favorable 3-month outcome (modified Rankin scale score 0-2). Results: By pairwise comparison of ROC curves, percent improvement was stronger than delta (p = 0.004) and MNI (p < 0.001) in predicting long-term outcome. First day improvement (FDI), defined as greater than 20% improvement, was a strong predictor of favorable 3-month outcome (OR 12.55, 95% CI 5.41-29.10). Recanalization (OR 3.30, 95% CI 1.28-8.45), absence of carotid T occlusion (OR 0.09, 95% CI 0.02-0.42) and hemorrhagic transformation (OR 0.25, 95% CI 0.09-0.73) were independent predictors of FDI. Independent predictors of favorable 3-month outcome were FDI, current smoking, absence of carotid T occlusion and hemorrhagic transformation. Conclusions: Percent improvement at 24 h after thrombolytic therapy is a useful surrogate marker for predicting the long-term outcome. Our findings highlight the importance of early stroke management.
| Original language | English |
|---|---|
| Pages (from-to) | 69-73 |
| Number of pages | 5 |
| Journal | Journal of the Neurological Sciences |
| Volume | 281 |
| Issue number | 1-2 |
| DOIs | |
| Publication status | Published - 2009 Jun 15 |
Fingerprint
All Science Journal Classification (ASJC) codes
- Neurology
- Clinical Neurology
Cite this
}
Prediction of long-term outcome by percent improvement after the first day of thrombolytic treatment in stroke patients. / Nam, Hyo Suk; Lee, Kyung Yul; Han, Sang Won; Kim, Seo Hyun; Lee, Jong Yun; Ahn, Seong Hwan; Kim, Dong Joon; Kim, Dong Ik; Nam, Chung Mo; Heo, Jihoe.
In: Journal of the Neurological Sciences, Vol. 281, No. 1-2, 15.06.2009, p. 69-73.Research output: Contribution to journal › Article
TY - JOUR
T1 - Prediction of long-term outcome by percent improvement after the first day of thrombolytic treatment in stroke patients
AU - Nam, Hyo Suk
AU - Lee, Kyung Yul
AU - Han, Sang Won
AU - Kim, Seo Hyun
AU - Lee, Jong Yun
AU - Ahn, Seong Hwan
AU - Kim, Dong Joon
AU - Kim, Dong Ik
AU - Nam, Chung Mo
AU - Heo, Jihoe
PY - 2009/6/15
Y1 - 2009/6/15
N2 - Background: We investigated a method for assessing early improvement and predictive factors of early and late outcomes in patients receiving thrombolytic therapy. Methods: A total of 160 consecutive patients who received thrombolytic therapy were included in the study. Using National Institutes of Health Stroke Scale (NIHSS) scores, percent improvement [(baseline NIHSS score - 24-hour NIHSS score) / baseline NIHSS score × 100] was calculated and compared with delta (baseline NIHSS score - 24-hour NIHSS score) and with major neurological improvement (MNI, NIHSS score of 0-1 or ≥ 8 point improvement at 24 h) by receiver operating characteristic (ROC) curve analysis. Finally, we investigated the independent predictors of improvement at 24 h after the thrombolytic therapy and of favorable 3-month outcome (modified Rankin scale score 0-2). Results: By pairwise comparison of ROC curves, percent improvement was stronger than delta (p = 0.004) and MNI (p < 0.001) in predicting long-term outcome. First day improvement (FDI), defined as greater than 20% improvement, was a strong predictor of favorable 3-month outcome (OR 12.55, 95% CI 5.41-29.10). Recanalization (OR 3.30, 95% CI 1.28-8.45), absence of carotid T occlusion (OR 0.09, 95% CI 0.02-0.42) and hemorrhagic transformation (OR 0.25, 95% CI 0.09-0.73) were independent predictors of FDI. Independent predictors of favorable 3-month outcome were FDI, current smoking, absence of carotid T occlusion and hemorrhagic transformation. Conclusions: Percent improvement at 24 h after thrombolytic therapy is a useful surrogate marker for predicting the long-term outcome. Our findings highlight the importance of early stroke management.
AB - Background: We investigated a method for assessing early improvement and predictive factors of early and late outcomes in patients receiving thrombolytic therapy. Methods: A total of 160 consecutive patients who received thrombolytic therapy were included in the study. Using National Institutes of Health Stroke Scale (NIHSS) scores, percent improvement [(baseline NIHSS score - 24-hour NIHSS score) / baseline NIHSS score × 100] was calculated and compared with delta (baseline NIHSS score - 24-hour NIHSS score) and with major neurological improvement (MNI, NIHSS score of 0-1 or ≥ 8 point improvement at 24 h) by receiver operating characteristic (ROC) curve analysis. Finally, we investigated the independent predictors of improvement at 24 h after the thrombolytic therapy and of favorable 3-month outcome (modified Rankin scale score 0-2). Results: By pairwise comparison of ROC curves, percent improvement was stronger than delta (p = 0.004) and MNI (p < 0.001) in predicting long-term outcome. First day improvement (FDI), defined as greater than 20% improvement, was a strong predictor of favorable 3-month outcome (OR 12.55, 95% CI 5.41-29.10). Recanalization (OR 3.30, 95% CI 1.28-8.45), absence of carotid T occlusion (OR 0.09, 95% CI 0.02-0.42) and hemorrhagic transformation (OR 0.25, 95% CI 0.09-0.73) were independent predictors of FDI. Independent predictors of favorable 3-month outcome were FDI, current smoking, absence of carotid T occlusion and hemorrhagic transformation. Conclusions: Percent improvement at 24 h after thrombolytic therapy is a useful surrogate marker for predicting the long-term outcome. Our findings highlight the importance of early stroke management.
UR - http://www.scopus.com/inward/record.url?scp=67349102293&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67349102293&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2009.02.365
DO - 10.1016/j.jns.2009.02.365
M3 - Article
VL - 281
SP - 69
EP - 73
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
IS - 1-2
ER -