title: The Ischemic Stroke Predictive Risk Score Predicts Early Neurological Deterioration.
abstract: BACKGROUND
  Although early neurological deterioration (END) during the acute stroke period is known to be directly associated with poor short- and long-term outcomes, few studies have investigated the ability to predict END. The aim of this study was to investigate whether there are differences in the occurrence of END according to the ischemic stroke predictive risk score (iScore), which was developed to predict short- and long-term mortality.
  
  
  METHODS
  We collected data from 2150 consecutive ischemic stroke patients who were admitted to 3 study hospitals between January 2012 and June 2014. END was defined as an increase (≥4) in the National Institutes of Health Stroke Scale score within the first 72 hours of stroke onset. We calculated the 30-day iScore for each patient to determine the relationship between the iScore and occurrence of END.
  
  
  RESULTS
  Among 2150 patients, END was observed in 146 patients (6.8%). There was a positive correlation between the iScore and occurrence of END. After adjusting for potential confounders, the iScore was independently associated with END (odds ratio: 1.217 per 20-point increase in iScore, 95% confidence interval: 1.121-1.321, P < .001). There was good correlation between observed and expected outcomes predicted by the iScore (Pearson correlation coefficient: r = .950, P < .001).
  
  
  CONCLUSIONS
  The iScore can predict the risk of END development within the acute stroke stage.
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea; Stroke Outcomes Research Unit, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kim
authors.affiliation: Department of Neurology, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Kangdong, Seoul, Republic of Korea.
authors.forename: Hye-Yeon
authors.initials: HY
authors.lastname: Choi
authors.affiliation: Department of Neurology, Changwon Fatima Hospital, Changwon, Republic of Korea.
authors.forename: Yo Han
authors.initials: YH
authors.lastname: Jung
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Joonsang
authors.initials: J
authors.lastname: Yoo
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyo Suk
authors.initials: HS
authors.lastname: Nam
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dongbeom
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
authors.affiliation: Stroke Outcomes Research Unit, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address: saposnikg@smh.ca.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Saposnik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology*; D009460:Neurologic Examination; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000209:etiology*
keywords: Ischemic stroke; outcome; prediction; risk score