title: The Scandinavian Stroke Scale is equally as good as The National Institutes of Health Stroke Scale in identifying 3-month outcome.
abstract: BACKGROUND
  The National Institutes of Health Stroke Scale (NIHSS) is the first choice among stroke scales. The Scandinavian Stroke Scale (SSS) is an alternative scale that is easy to apply in the clinic.
  
  
  OBJECTIVE
  To compare the ability of the SSS with that of the NIHSS in identifying patients who are dead or dependent at 3-month follow-up.
  
  
  METHODS
  A prospective study including patients with acute stroke. NIHSS and SSS measurements were obtained during index hospital stay. The receiver operating characteristics curve was used to determine the optimal dichotomization of the NIHSS and the SSS by using a modified Rankin Scale (mRS) >2 at 3-month follow-up as the criterion standard. Positive and negative predictive values (PPV and NPV) were calculated.
  
  
  RESULTS
  A total of 104 patients (mean age 79 years, 57.7% men) were included. Median (interquartile range (IQR)) NIHSS and SSS score were 6.0 (2.0-11.8) and 43.5 (30.0-51.0), respectively. The areas under the curve were 0.769 and 0.796 for NIHSS and SSS, respectively, χ2 (p = 0.303). The best cut-off point for NIHSS was 6/7 points (PPV = 76.2%, NPV = 69.0%) while for SSS it was 42/43 points (PPV = 71.4%, NPV = 73.2%).
  
  
  CONCLUSIONS
  The SSS was as good as the NIHSS in identifying patients who had died or were dependent at 3-month follow-up. The measurement properties of the SSS should be investigated further.
authors.affiliation: Department of Neuroscience, NTNU, Faculty of Medicine, Postbox 8905 , NO-7491 Trondheim, Norway. torunn.askim@ntnu.no.
authors.forename: Torunn
authors.initials: T
authors.lastname: Askim
authors.forename: Julie
authors.initials: J
authors.lastname: Bernhardt
authors.forename: Leonid
authors.initials: L
authors.lastname: Churilov
authors.forename: Bent
authors.initials: B
authors.lastname: Indredavik
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009316:National Institutes of Health (U.S.); D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012537:Scandinavian and Nordic Countries; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality; D014481:United States