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Title
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Clinical, biochemical and neuroimaging parameters after thrombolytic therapy predict long-term stroke outcome
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Author
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Abstract
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| Introduction: We investigated the predictive value of standard neurological evaluation, a commercially available biomarker assay and neuroimaging in the subacute phase for outcome after thrombolytic therapy in ischemic stroke. Methods: Thirty-four consecutive ischemic stroke patients were evaluated by means of the NIH Stroke Scale (NIHSS72), the Triage® Stroke Panel (MMX72) and standardized infarct volumetry at 72 h after treatment with intravenous recombinant tissue plasminogen activator or intra-arterial urokinase. Outcome was assessed by the modified Rankin Scale (mRS) at 3 months after the stroke. Results: NIHSS72, MMX72 and infarct volume correlated significantly with the mRS score at month 3 and emerged as independent outcome predictors from logistic regression analysis. NIHSS72 is the best predictor for outcome, but its accuracy increases by 9 and 6% when combined with MMX72 and infarct volumetry, respectively. The combined use of NIHSS72 and MMX72 allows long-term outcome prediction with 97% accuracy, which is not further improved by infarct volumetry. Conclusions: Routine clinical evaluation, bedside testing of biochemical markers by the Triage Stroke Panel and infarct volumetry on neuroimaging at 72 h after thrombolytic therapy are predictors for long-term outcome of ischemic stroke patients. Clinical assessment is the most reliable parameter for outcome prediction, but its predictive value is substantially improved when combined with the biomarker panel. |
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Language
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English
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Source (journal)
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European neurology. - Basel
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Publication
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Basel
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2009
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ISSN
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0014-3022
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DOI
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10.1159/000215876
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Volume/pages
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62
:1
(2009)
, p. 9-15
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ISI
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000266343000002
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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