What Is the NIHSS Stroke Scale? - Oren Zarif - Nih Stroke Scale
The NIHSS is an important tool to determine the severity of a stroke patient's neurological deficit. It can be administered to virtually any stroke patient. However, many scale items cannot be validated in severe stroke cases. Additionally, patients cannot complete the scale by proxy or self-report. This is why the scale was not originally designed for widespread use. Hence, it is important to know more about its history, clinimetric properties, and bedside administration before mandating its use.
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The NIHSS is used to determine the severity of a stroke. The higher the score, the higher the risk of a poor outcome. Patients with an aNIHSS of seven to ten had a 54% probability of an excellent outcome. Similarly, patients with a score of eleven to fifteen had a 23% chance of an excellent outcome. However, a high score indicates that the patient has a low chance of a good outcome.
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However, the NIHSS score isn't completely accurate in predicting stroke outcomes. It is less accurate in cases of isolated cortex stroke, but it is still reliable enough to determine the course of treatment. In a study by Adams et al., a total of 1,268 acute stroke patients were studied. Scores of the NIHSS were collected at baseline, seven-day follow-up, and three-month follow-up. As the results showed, a score of 16 or more predicted a high probability of death. A score of six or less, however, indicated a good chance of a patient's recovery. Each point raised on the NIHSS scale reduced the probability of a good outcome by about 25 percent.
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The NIHSS is composed of 11 elements that are assessed by a trained panel. A patient's performance on each element is assessed using a scale ranging from zero to four. There is also a scale from zero to two. The higher the score, the worse the patient's condition is. The first element is the level of consciousness, with three sub-elements measuring alertness, responsiveness, and ability to follow simple commands.
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The NIHSS is a standardized score used by healthcare professionals to determine the degree of impairment caused by a stroke. It is used to determine how severe a stroke is, whether it is improving or deteriorating over time. Having a consistent scale will help clinicians and researchers make appropriate decisions about treatment. It is important to consider the NIHSS score when deciding on a treatment plan for a stroke patient.
The NIHSS measures the severity of neurological impairment associated with a stroke.
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Initially designed for research purposes, the NIHSS has been widely adopted in clinical practice. It provides a common language for healthcare providers to communicate with patients. The NIHSS is composed of 15 items grading cognitive functions, extraocular movement, motor strength, and sensory impairment. It is also helpful for identifying patients who are likely to benefit from reperfusion therapies.
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The NIHSS is a valid tool when used in the context of stroke. It is used to assess the severity of the disease and provide guidance to doctors in stroke care. The results of NIHSS studies have led to improvements in stroke research. The NIHSS Scree plot shows key prognostic components. These components have been tested using receiver-operating characteristic curves. These curves are shown in the following figure.
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Researchers have used the NIHSS to assess clinical outcomes in acute stroke patients. One study examined three hundred nine patients treated with intravenous recombinant tissue plasminogen activator. They used univariate and multivariate logistic regression analysis to determine the best predictor of clinical outcome at day sixty. Specifically, the NIHSS score decreased patients' odds of recovery by 75% for every five points above the baseline score.
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NIHSS reliability has also been studied. The original scale showed adequate to good test-retest, inter-rater, and intra-rater reliability. Six studies reported adequate to excellent inter-rater reliability. Two studies reported improvements from poor to excellent inter-rater reliability. These studies also confirmed that the mNIHSS was as valid as the NIHSS. These studies support the use of the NIHSS as a diagnostic tool for stroke.
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