Clinical, biochemical and neuroimaging parameters after thrombolytic therapy predict long-term stroke outcome.

Abstract:

INTRODUCTION:We investigated the predictive value of standard neurological evaluation, a commercially available biomarker assay and neuroimaging in the subacute phase for outcome after thrombolytic therapy in ischemic stroke. METHODS:Thirty-four consecutive ischemic stroke patients were evaluated by means of the NIH Stroke Scale (NIHSS(72)), the Triage(R) Stroke Panel (MMX(72)) and standardized infarct volumetry at 72 h after treatment with intravenous recombinant tissue plasminogen activator or intra-arterial urokinase. Outcome was assessed by the modified Rankin Scale (mRS) at 3 months after the stroke. RESULTS:NIHSS(72), MMX(72) and infarct volume correlated significantly with the mRS score at month 3 and emerged as independent outcome predictors from logistic regression analysis. NIHSS(72) is the best predictor for outcome, but its accuracy increases by 9 and 6% when combined with MMX(72) and infarct volumetry, respectively. The combined use of NIHSS(72) and MMX(72) allows long-term outcome prediction with 97% accuracy, which is not further improved by infarct volumetry. CONCLUSIONS:Routine clinical evaluation, bedside testing of biochemical markers by the Triage Stroke Panel and infarct volumetry on neuroimaging at 72 h after thrombolytic therapy are predictors for long-term outcome of ischemic stroke patients. Clinical assessment is the most reliable parameter for outcome prediction, but its predictive value is substantially improved when combined with the biomarker panel.

journal_name

Eur Neurol

journal_title

European neurology

authors

Brouns R,Sheorajpanday R,Kunnen J,De Surgeloose D,De Deyn PP

doi

10.1159/000215876

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

9-15

issue

1

eissn

0014-3022

issn

1421-9913

pii

000215876

journal_volume

62

pub_type

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