title: National Institutes of Health Stroke Scale-Time Score Predicts Outcome after Endovascular Therapy in Acute Ischemic Stroke: A Retrospective Single-Center Study.
abstract: BACKGROUND
  Outcomes after successful endovascular therapy in acute ischemic stroke are associated with onset-to-reperfusion time (ORT) and the National Institutes of Health Stroke Scale (NIHSS) score. In intravenous recombinant tissue plasminogen activator therapy, the NIHSS-time score, calculated by multiplying onset-to-treatment time with the NIHSS score, has been shown to predict clinical outcomes. In this study, we assessed whether a similar combination of the ORT and the NIHSS score can be applied to predict the outcomes after endovascular therapy.
  
  
  METHODS
  We retrospectively reviewed the charts of 128 consecutive ischemic stroke patients with successful reperfusion after endovascular therapy. We analyzed the association of the ORT, the NIHSS score, and the NIHSS-time score with good outcome (modified Rankin Scale score ≤ 2 at 3 months).
  
  
  RESULTS
  Good outcome rates for patients with NIHSS-time scores of 84.7 or lower, scores higher than 84.7 up to 127.5 or lower, and scores higher than 127.5 were 72.1%, 44.2%, and 14.3%, respectively (P < .01). Multivariate logistic regression analysis revealed that the NIHSS-time score was an independent predictor of good outcomes (odds ratio, .372; 95% confidence interval, .175-.789) after adjusting for age, sex, internal carotid artery occlusion, plasma glucose level, ORT, and NIHSS score.
  
  
  CONCLUSIONS
  The NIHSS-time score can predict good clinical outcomes after endovascular treatment.
authors.affiliation: Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan. Electronic address: ktodo@kcho.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Todo
authors.affiliation: Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sakai
authors.affiliation: Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kono
authors.affiliation: Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Hoshi
authors.affiliation: Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Imamura
authors.affiliation: Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Hidemitsu
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kohara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003661:Decision Support Techniques; D004185:Disability Evaluation; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Ischemic stroke; endovascular recanalization; endovascular therapy; outcome predictive factors; revascularization