title: Clinical, biochemical and neuroimaging parameters after thrombolytic therapy predict long-term stroke outcome.
abstract: BACKGROUND
  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.
authors.affiliation: Department of Neurology and Memory Clinic, ZNA Middelheim Hospital, Antwerp, Belgium.
authors.forename: Raf
authors.initials: R
authors.lastname: Brouns
authors.forename: Rishi
authors.initials: R
authors.lastname: Sheorajpanday
authors.forename: Jan
authors.initials: J
authors.lastname: Kunnen
authors.forename: Didier
authors.initials: D
authors.lastname: De Surgeloose
authors.forename: Peter Paul
authors.initials: PP
authors.lastname: De Deyn
mesh_terms: D000368:Aged; D015415:Biomarkers; D001921:Brain / Q000187:drug effects / Q000473:pathology; D002545:Brain Ischemia / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007118:Immunoassay; D016015:Logistic Models; D008297:Male; D009460:Neurologic Examination; D016017:Odds Ratio; D011379:Prognosis; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator