title: Distribution of National Institutes of Health stroke scale in the Cincinnati/Northern Kentucky Stroke Study.
abstract: OBJECTIVE
  Little is known about the distribution of National Institutes of Health Stroke Scale (NIHSS) scores from patients with ischemic stroke sampled from population-based studies. We describe the distribution of NIHSS in ischemic stroke cases from the Cincinnati/Northern Kentucky Stroke Study.
  
  
  METHODS
  Within a biracial population of 1.3 million, all strokes among area residents in 2005 were ascertained by screening discharge records at local hospitals and outpatient clinics. A sampling scheme was developed to ascertain additional cases presenting to physician offices and nursing homes, not identified through the other sources. All confirmed ischemic stroke cases underwent chart abstraction, and a retrospective NIHSS (rNIHSS) score (range, 0-42) was generated on the basis of initial physician examination findings.
  
  
  RESULTS
  There were 2233 ischemic stroke cases identified during the 12-month study. The overall median rNIHSS score was 3 (interquartile range, 1-7). Median rNIHSS score was 3, 7, and 1, respectively, for stroke cases ascertained through the admitted, in-hospital, and out-of-hospital sources. Median rNIHSS was significantly higher in subjects ≥80 years compared with younger cases (4 versus 3).
  
  
  CONCLUSIONS
  More than half of all ischemic stroke cases have mild symptom severity on initial presentation (ie, rNIHSS≤3). Monitoring trends in NIHSS represents a legitimate target for population-based surveillance efforts.
authors.affiliation: From the Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI (M.R.); Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital, OH (J.K.); and Neuroscience Institute (K.A., C.M., M.F., D.W., P.K., S.F., B.K., D.K.), Department of Neurology (K.A., C.M., M.F., D.W., P.K., S.F., B.K., D.K.), and Department of Emergency Medicine (O.A.), University of Cincinnati, OH.
authors.forename: Mathew
authors.initials: M
authors.lastname: Reeves
authors.forename: Jane
authors.initials: J
authors.lastname: Khoury
authors.forename: Kathleen
authors.initials: K
authors.lastname: Alwell
authors.forename: Charles
authors.initials: C
authors.lastname: Moomaw
authors.forename: Matthew
authors.initials: M
authors.lastname: Flaherty
authors.forename: Daniel
authors.initials: D
authors.lastname: Woo
authors.forename: Pooja
authors.initials: P
authors.lastname: Khatri
authors.forename: Opeolu
authors.initials: O
authors.lastname: Adeoye
authors.forename: Simona
authors.initials: S
authors.lastname: Ferioli
authors.forename: Brett
authors.initials: B
authors.lastname: Kissela
authors.forename: Dawn
authors.initials: D
authors.lastname: Kleindorfer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D006760:Hospitalization; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology
keywords: severity; stroke