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The National Institutes of Health Stroke Scale (NIHSS) - Oren Zarif - Nih Stroke Scale


The NIHSS is an important tool in the assessment of stroke patients. Its administration takes less than ten minutes and provides a reliable baseline for stroke treatment assessment. However, it can also be prone to a ceiling effect in patients with more severe strokes. As well, the NIHSS cannot be completed by a patient's self-report or proxy. However, video telemedicine measurement appears reliable, and could be a viable option for remote assessment. Further, there is no special equipment and minimal space required.

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Generally, high aNIHSS scores predict poor outcomes. A score of ten or greater suggests a poor prognosis. For example, a NIHSS score of 10 indicates a 90% chance of severe disability and a poor quality of life. The lower the score, the better, and the less severe the outcome is. But in a study done in Japan, the aNIHSS score was associated with a better outcome than the NIHSS.

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The NIHSS predicts the outcomes of patients quite accurately, though the score is not entirely accurate in isolated cortex strokes. In general, a patient with a score of 16 or more is at high risk of dying. By contrast, a score of six or less indicates a high chance of recovery. Moreover, for every 1-point increase on the NIHSS, a patient's chances of a positive outcome decrease by approximately 17 percent. The NIHSS score will help doctors determine the best course of action after stroke.

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NIHSS scores vary from zero to 42. Higher scores indicate more severe stroke. The NIHSS is developed by a panel of experts and through a modified Delphi process. While it was initially developed to measure differences among interventions in clinical trials, it has since become widely used for initial assessment and planning post-acute care. It is highly effective in identifying stroke severity and improving quality of life. There are numerous benefits to using the NIHSS.

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Despite its limited validity in predicting the outcome of ischemic stroke, the NIHSS has shown significant improvements in clinical outcomes after just a week. Although only four of the fifteen items improved (facial palsy, plantar reflex, dysarthria, and language), the remaining 10 items changed about 25% over seven days. The aNIHSS has higher interrater reliability than the 24-hour NIHSS.

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While NIHSS scores are not 100% accurate, they can help physicians determine whether a patient is improving or worsening. With accurate results, patients can make informed decisions about stroke treatment. And, thanks to the NIHSS, the results of clinical trials are more accurate than ever before. So, it's a good tool for researchers and clinicians. The NIHSS is also an excellent resource for assessing the overall health of a stroke patient.

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NIHSS training has multiple venues and is becoming more popular as a result of the need for accurate outcomes measurement. There are also multiple online services offering training videos on NIHSS. A robust training strategy is necessary to ensure the validity and reliability of the NIHSS. Besides the NIHSS training materials, there are also web-based courses that are available for a nominal fee. But there is no guarantee of reproducibility, so it's better to invest a little time in research before you commit to a costly certification program.

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The NIH stroke scale is divided into several sub-elements. Each element is evaluated with a score from 0 to 4 (in some cases, only from 0 to 2), with a higher score indicating more severe impairment. The first element of the scale, level of consciousness, is comprised of 3 sub-elements. These test a patient's alertness and ability to follow simple commands.

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In the NIHSS Scree plot, key prognostic components are identified. These components are explained by the principal components of the score. After the study was conducted, researchers determined which variables were more predictive of outcome in patients than others. Using receiver-operating characteristic curves, they compared the areas under the curves for the NIHSS baseline and the mRS 0-2, 4, and 6-point scales.

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