Hong Kong Med J 2008;14:367-70 | Number 5, October 2008
Using the National Institutes of Health Stroke Scale (NIHSS) to predict the mortality and outcome of patients with intracerebral haemorrhage
CM Cheung, TH Tsoi, Sonny FK Hon, M Au-Yeung, KL Shiu, CN Lee, CY Huang
Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
OBJECTIVES. To investigate whether the National Institutes of Health Stroke Scale (NIHSS) can be used to predict mortality and functional outcome in patients presenting with intracerebral haemorrhage.
DESIGN. Retrospective study of a prospectively collected cohort.
SETTING. Regional hospital, Hong Kong.
PATIENTS. A cohort of 359 patients presented to our hospital from 1996 to 2001 with their first-ever stroke and intracerebral haemorrhage.
MAIN OUTCOME MEASURES. The sensitivity and specificity of the NIHSS with a cut-off point of 20 in predicting mortality at 30 days and 5 years, and a favourable functional outcome at 5 years.
RESULTS. A total of 359 patients were available for analysis and were divided into three subgroups according to the site and the size of the haematoma. The NIHSS can predict 30-day mortality with a sensitivity of 81% and a specificity of 90%. The NIHSS can predict 5-year mortality with a sensitivity of 57% and a specificity of 92%. In predicting favourable functional outcomes at 5 years, the NIHSS had a sensitivity of 98% and a specificity of 16%.
CONCLUSIONS. The NIHSS performed on admission can be used to predict mortality at 30 days and 5 years as well as favourable functional outcome at 5 years, all with an acceptable sensitivity and specificity.
Key words: Cerebral hemorrhage; Outcome assessment (health care); Predictive value of tests; Sensitivity and specificity
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