title: NIHSS-time score easily predicts outcomes in rt-PA patients: the SAMURAI rt-PA registry.
abstract: BACKGROUND
  We aimed to devise a scale comprising a simple multiplication of initial National Institutes of Health Stroke Scale (NIHSS) score and onset-to-treatment time (OTT) as a scale for predicting outcomes after recombinant tissue plasminogen activator (rt-PA) therapy.
  
  
  METHODS
  Data from rt-PA patients in 10 stroke centers in Japan were investigated. NIHSS-time score was calculated as initial NIHSS score×OTT.
  
  
  RESULTS
  Subjects comprised 526 patients. Median NIHSS score was 12 (7-18), and median OTT was 2.42 h (2.00-2.75 h). Median NIHSS-time score was 27.7 (16.9-41.7). Good (modified Rankin Scale [mRS] 0-1) and poor (mRS 4-6) outcome rates at 3months for patients with NIHSS-time scores ≤ 10 were 71.1% and 7.8%, compared to 54.7% and 16.5% for scores >10 and ≤ 20, 38.9% and 31.9% for scores >20 and ≤ 30, 25.0% and 44.6% for scores >30 and ≤ 40, and 17.4% and 61.8% for scores >40, respectively. Cut-off NIHSS-time scores to predict good and poor outcomes with 50% probability were defined as 20 and 40, respectively. Multivariate logistic regression analysis revealed NIHSS-time score as an independent predictor of good (odds ratio [OR], 0.587; 95% confidence interval [CI], 0.422-0.818, p=0.002) and poor (OR, 1.756; 95%CI, 1.227-2.514, p=0.002) outcomes after adjusting for age, sex, NIHSS score, OTT, Alberta Stroke Program Early CT Score, internal carotid artery occlusion, and glucose level.
  
  
  CONCLUSIONS
  NIHSS-time score predicts clinical outcomes in rt-PA patients.
authors: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan. aojyun@med.kawasaki-m.ac.jp
authors: Junya
authors: J
authors: Aoki
authors: Kazumi
authors: K
authors: Kimura
authors: Masatoshi
authors: M
authors: Koga
authors: Kazuomi
authors: K
authors: Kario
authors: Jyoji
authors: J
authors: Nakagawara
authors: Eisuke
authors: E
authors: Furui
authors: Yoshiaki
authors: Y
authors: Shiokawa
authors: Yasuhiro
authors: Y
authors: Hasegawa
authors: Satoshi
authors: S
authors: Okuda
authors: Hiroshi
authors: H
authors: Yamagami
authors: Yasushi
authors: Y
authors: Okada
authors: Kensaku
authors: K
authors: Shibazaki
authors: Yuki
authors: Y
authors: Sakamoto
authors: Kazunori
authors: K
authors: Toyoda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.) / Q000592:standards*; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014481:United States
chemical_list: D010959:Tissue Plasminogen Activator