Abstract T P290: Predictors of Outcome in Patients Presenting with Acute Ischemic Stroke and Mild Stroke Scale Scores

Abstract

Objective: Although NIHSS is a known predictor of outcome in acute ischemic stroke, there are other factors like age, ambulatory status and ability to swallow that may be predictors of outcome, but are not assessed by the traditional NIHSS. The aim of this retrospective review was to identify predictors of outcome in mild ischemic stroke. METHODS: Discharge outcomes from patients who presented to our large academic stroke center with acute ischemic stroke from 2005-2013 were retrospectively reviewed. Of 7189 patients reviewed, 2597 had initial NIHSS <5. At the time of abstract submission data was available for 971 patients. Outcome measures were modified rankin score (MRS) and discharge to home. RESULTS: In this retrospective review, 64% of patients with NIHSS 0-4 were discharged directly home independent of treatment. The mean age of patients discharged to home was 62 and of those not being discharged to home was 70. Of those patients discharged to home, 99% were able to ambulate independently and 98% passed their dysphagia screen. Of patients unable to be discharged directly to home, 6% were not ambulating independently and 17% did not pass their dysphagia screen. Univariate analysis of variance revealed a significant effect of dysphagia screen (p < 0.001), ability to ambulate independently (p < 0.001), and age (p < 0.001) on both discharge to home and MRS 0-1. Multivariate analysis of variance revealed no significant interaction between ability to ambulate, dysphagia and age on discharge to home or MRS 0-1 (p > 0.05). CONCLUSIONS: In patients with mild stroke scale scores defined as NIHSS 0-4, several factors including age, ambulatory status, and ability to swallow may be independent predictors of functional outcome. These data support the development of a modified grading system for assessing functional outcome in mild stroke that considers these factors.