OBJECTIVE:

We determined the one-month prognostic value of the National Institute of Health Stroke Scale (NIHSS) in stroke patients, as quantified by the Barthel Index (BI) in the emergency department (ED).

METHODS:

Ninety-four patients with cerebrovascular accident (CVA) who were diagnosed as acute stroke in our university hospital-based ED were included in the study. After evaluation, all patients received NIHSS and GCS scores by the emergency physician on duty. Thirty days after ictus, all patients were called by phone and data regarding activities of daily living included in the BI were recorded.

RESULTS:

The relationship of total NIHSS scores with total BI scores was found to be statistically significant (r=0.633, p<0.001). Scores of best gaze (NIHSS 2), visual field (NIHSS 3), motor function of upper and lower extremities (NIHSS 5 and 6, respectively), speech (NIHSS 9), dysarthria (NIHSS 10), and neglect (NIHSS 11) were found to be significantly related with survival (c2= 24.634, 21.684, 14.745, 8.480, 15.061, 13.752, 24.624, respectively). Ataxia (NIHSS 7) (c2 =1.315) was not associated with mortality.

CONCLUSIONS:

Total NIHSS scores were found to be significantly related with BI in ED stroke patients. Except for ataxia, the subcomponents of the NIHSS were positively associated with one-month mortality. This scale may be appropriate for routine use in patients with CVA in the ED setting.

Keywords: Acute stroke, NIHSS, outcome, mortality