title: The sNIHSS-4 predicts outcome in right and left anterior circulation strokes.
abstract: OBJECTIVE
  Stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS) is a strong predictor of functional outcome. A short version, the sNIHSS-5, scoring only strength in right and left leg, gaze, visual fields and language, was developed for use in the prehospital setting. Because scoring both legs in anterior circulation strokes is not contributive, we assessed the value of a 4-item score (the sNIHSS-4), omitting the item 'strength in the unaffected leg', in predicting stroke outcome.
  
  
  METHODS
  The study population consisted of anterior circulation ischemic stroke patients who participated in the LUB-INT-9 trial. We included all patients in whom the following data were available: NIHSS within 6h after stroke onset and daily between days 2 and 5, and the 12-week modified Rankin Scale (mRS) score. Poor outcome was defined as a mRS score>3.
  
  
  RESULTS
  There was an excellent correlation between the NIHSS and sNIHSS-4 at all time points for both left and right-sided strokes. Scores at day 2 were a good predictor of poor outcome. Cutoff scores for NIHSS and sNIHSS-4 at day 2 were 15 and 5 in left hemispheric strokes, and 12 and 4 in right hemispheric strokes.
  
  
  CONCLUSIONS
  The sNIHSS-4 is as good as the NIHSS at predicting stroke outcome in both right and left anterior circulation strokes.
authors.affiliation: Department of Neurology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium. sylvie.deraedt@uzbrussel.be
authors.forename: S
authors.initials: S
authors.lastname: De Raedt
authors.forename: R
authors.initials: R
authors.lastname: Brouns
authors.forename: A
authors.initials: A
authors.lastname: De Smedt
authors.forename: M J H
authors.initials: MJ
authors.lastname: Aries
authors.forename: M
authors.initials: M
authors.lastname: Uyttenboogaart
authors.forename: G J
authors.initials: GJ
authors.lastname: Luijckx
authors.forename: J
authors.initials: J
authors.lastname: De Keyser
mesh_terms: D000368:Aged; D019540:Area Under Curve; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D020521:Stroke / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome