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Journal articles on the topic "Score de rankin"
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ElHabr, Andrew K., Jeffrey M. Katz, Jason Wang, et al. "Predicting 90-day modified Rankin Scale score with discharge information in acute ischaemic stroke patients following treatment." BMJ Neurology Open 3, no. 1 (2021): e000177. http://dx.doi.org/10.1136/bmjno-2021-000177.
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ObjectivesTo understand variability in modified Rankin Scale scores from discharge to 90 days in acute ischaemic stroke patients following treatment, and examine prediction of 90-day modified Rankin Scale score by using discharge modified Rankin Scale and discharge disposition.Materials and methodsRetrospective analysis of acute ischaemic stroke patients following treatment was performed from January 2016 to March 2020. Data collection included demographic and clinical characteristics and outcomes data (modified Rankin Scale score at discharge, 30 days and 90 days and discharge disposition). Pearson’s χ2 test assessed statistical differences in distribution of modified Rankin Scale scores at discharge, 30 days and 90 days. The predictive power of discharge modified Rankin Scale score and disposition quantified the association with 90-day outcome.ResultsA total of 280 acute ischaemic stroke patients (65.4% aged ≥65 years, 47.1% female, 60.7% white) were included in the analysis. The modified Rankin Scale score significantly changed between 30 and 90 days from discharge (p<0.001) after remaining stable from discharge to 30 days (p=0.665). The positive and negative predictive values of an unfavourable long-term outcome for discharge modified Rankin Scale scores of 3–5 were 67.7% (95% CI 60.4% to 75.0%) and 82.0% (95% CI 75.1% to 88.8%), and for non-home discharge disposition were 72.4% (95% CI 64.5% to 80.2%) and 74.5% (95% CI 67.8% to 81.3%), respectively.ConclusionsDischarge modified Rankin Scale score and non-home discharge disposition are good individual predictors of 90-day modified Rankin Scale score for ischaemic stroke patients following treatment.
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Sarder, AH, BK Das, KJ Mondal, MA Kabir, B. Basu, and MM Alam. "30-days’ outcome of haemorrhagic stroke: correlation between intracerebral hemorrhage score and modified Rankin score." Mediscope 5, no. 1 (2018): 10–14. http://dx.doi.org/10.3329/mediscope.v5i1.36720.
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Intracerebral hemorrhage (ICH) constitutes 10% to 15% of all strokes. Within 30 days reported mortality is 35-52% and only 20% is functionally independent in 6 months. Despite several existing outcome prediction models for ICH, modified Rankin scale is found to be best predictor of outcome in early and long term period. To find out 30-day mortality in ICH and predict outcome based on modified Rankin score. In this study, 48 patients presenting with acute ICH presenting to a tertiary hospital in Khulna were enrolled. The 30-day mortality and disability were recorded, and ICH score along with modified Rankin score at presentation were calculated. In this study, the 30-day mortality rate was 27.1%; regression analysis showed the correlation between the scores (as measured by modified Rankin scale) for patient disability, intraventricular hemorrhage, the Glasgow Coma score, and volume of hematoma (>30 ml vs <30 ml) were significantly correlated with corresponding ICH scores. The ICH scale is a simple clinical grading scale which can predict mortality as well as disability in haemorrhagic stroke within 30 days that can be helpful to physicians in prioritization of their patient management and forecasting about prognosis.Mediscope Vol. 5, No. 1: Jan 2018, Page 10-14
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Weiss, Daniel, Bastian Kraus, Christian Rubbert, et al. "Systematic evaluation of computed tomography angiography collateral scores for estimation of long-term outcome after mechanical thrombectomy in acute ischaemic stroke." Neuroradiology Journal 32, no. 4 (2019): 277–86. http://dx.doi.org/10.1177/1971400919847182.
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Purpose This study compares computed tomography angiography-based collateral scoring systems in regard to their inter-rater reliability and potential to predict functional outcome after endovascular thrombectomy, and relates them to parenchymal perfusion as measured by computed tomography perfusion. Methods Eighty-four patients undergoing endovascular thrombectomy in anterior circulation ischaemic stroke were enrolled. Modified Tan Score, Miteff Score, Maas Score and Opercular Index Score ratio were assessed in pre-interventional computed tomography angiographies independently by two readers. Collateral scores were tested for inter-rater reliability by weighted-kappa, for correlations with three-months modified Rankin Scale, and their potential to differentiate between patients with favourable (modified Rankin Scale ≤2) and poor outcome (modified Rankin Scale ≥3). Correlations with relative cerebral blood volume and relative cerebral blood flow were tested in patients with available computed tomography perfusion. Results Very good inter-rater reliability was found for Modified Tan, Miteff and Opercular Index Score ratio, and substantial reliability for Maas. There were no significant correlations between collateral scores and three-months modified Rankin Scale, but significant group differences between patients with favourable and poor outcome for Maas, Miteff and Opercular Index Score ratio. Miteff and Maas were significant predictors of favourable outcome in binary logistic regression analysis. Miteff best differentiated between both outcome groups in receiver-operating characteristics, and Maas reached highest sensitivity for favourable outcome prediction of 96%. All collateral scores significantly correlated with mean relative cerebral blood volume and relative cerebral blood flow. Conclusions Computed tomography angiography scores are valuable in estimating functional outcome after mechanical thrombectomy and reliable across readers. The more complex scores, Maas and Miteff, show the best performances in predicting favourable outcome.
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Schmidt, Felix A., Eric M. Liotta, Shyam Prabhakaran, Andrew M. Naidech, and Matthew B. Maas. "Assessment and comparison of the max-ICH score and ICH score by external validation." Neurology 91, no. 10 (2018): e939-e946. http://dx.doi.org/10.1212/wnl.0000000000006117.
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ObjectiveWe tested the hypothesis that the maximally treated intracerebral hemorrhage (max-ICH) score is superior to the ICH score for characterizing mortality and functional outcome prognosis in patients with ICH, particularly those who receive maximal treatment.MethodsPatients presenting with spontaneous ICH were enrolled in a prospective observational study that collected demographic and clinical data. Mortality and functional outcomes were measured by using the modified Rankin Scale at 3 months. The ICH score and max-ICH score incorporate measures of symptom severity, age, hematoma volume, hematoma location, and intraventricular hemorrhage, with the max-ICH score also including a term for oral anticoagulation and having 16 score categories vs 11 for the ICH score. We compared the area under the receiver operating characteristic curve (AUC) for the ICH score and max-ICH score for both mortality and poor functional outcome, defined as modified Rankin Scale scores 4–6.ResultsWe analyzed outcomes for 372 patients, including 71 patients (19%) in whom care limitation/withdrawal of life support was instituted. Both the ICH score and max-ICH score showed good prognostic performance for 3-month mortality and poor functional outcomes in the full group as well as the subgroup with maximal treatment (i.e., no care limitations; AUC range 0.80–0.86), with no significant difference in AUC between the scores for either endpoint in either group.ConclusionsExternal validation with direct comparison of the ICH score and max-ICH score shows that their prognostic performance is not meaningfully different. Alternatives to simple scores are likely needed to improve prognostic estimates for patient care decisions.
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Cramer, Steven C., Vu Le, Jeffrey L. Saver, et al. "Intense Arm Rehabilitation Therapy Improves the Modified Rankin Scale Score." Neurology 96, no. 14 (2021): e1812-e1822. http://dx.doi.org/10.1212/wnl.0000000000011667.
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ObjectiveTo evaluate the effect of intensive rehabilitation on the modified Rankin Scale (mRS), a measure of activities limitation commonly used in acute stroke studies, and to define the specific changes in body structure/function (motor impairment) most related to mRS gains.MethodsPatients were enrolled >90 days poststroke. Each was evaluated before and 30 days after a 6-week course of daily rehabilitation targeting the arm. Activity gains, measured using the mRS, were examined and compared to body structure/function gains, measured using the Fugl-Meyer (FM) motor scale. Additional analyses examined whether activity gains were more strongly related to specific body structure/function gains.ResultsAt baseline (160 ± 48 days poststroke), patients (n = 77) had median mRS score of 3 (interquartile range, 2–3), decreasing to 2 [2–3] 30 days posttherapy (p < 0.0001). Similarly, the proportion of patients with mRS score ≤2 increased from 46.8% at baseline to 66.2% at 30 days posttherapy (p = 0.015). These findings were accounted for by the mRS score decreasing in 24 (31.2%) patients. Patients with a treatment-related mRS score improvement, compared to those without, had similar overall motor gains (change in total FM score, p = 0.63). In exploratory analysis, improvement in several specific motor impairments, such as finger flexion and wrist circumduction, was significantly associated with higher likelihood of mRS decrease.ConclusionsIntensive arm motor therapy is associated with improved mRS in a substantial fraction (31.2%) of patients. Exploratory analysis suggests specific motor impairments that might underlie this finding and may be optimal targets for rehabilitation therapies that aim to reduce activities limitations.Clinical TrialClinicaltrials.gov identifier: NCT02360488.Classification of EvidenceThis study provides Class III evidence that for patients >90 days poststroke with persistent arm motor deficits, intensive arm motor therapy improved mRS in a substantial fraction (31.2%) of patients.
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Karki, Karuna Tamrakar, Binod Bhattarai, Sunil Munakomi, and Pramod K. Chaudhary. "Microsurgical Approach to Hypertensive Deep Nuclear Bleed: Preliminary Experience and Short Term Outcome." Nepal Journal of Neuroscience 16, no. 3 (2019): 50–54. http://dx.doi.org/10.3126/njn.v16i3.27356.
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Efficacy of surgical evacuation of hypertensive deep nuclear bleed with or without decompressivecraniectomy remains controversial. Our paper mainly focuses on short-term preliminary experience on the evacuation of hypertensive deep nuclear bleed via transsylvian approach in reducing secondary brain injury for better neurological outcome. In between August 2012 to October 2013, 25surgically managed patients with hypertensive deep nuclear bleed were reviewed retrospectively. Among them, 13 cases underwent transsylvianevacuation of hematoma.84.6% were males. Age ranged between 38 to68 years with a mean age of 50.23 with standard deviation of 8.29 years. The size of hematoma measured in computed tomography scan ranged from 48 to 156 ml (mean 69 ml with standard deviation 38.28 ml). Nine hypertensive patients were taking medication on an irregular basis. The remaining had never taken antihypertensive agents before the ictus. 7/15 was the lowest Glasgow Coma Scale score and 13/15 was the highest score on arrival to the emergency room. Eight cases showed near-total evacuation of hematoma on repeated scan was taken after24 hours of surgery. One patient underwent transsylvian evacuation in 2nd postoperative day after recollection following the trans frontale vacation of right putaminal bleed. Two patients died on 3rd and 4th post-operative day respectively (GOS=1). GOS score during discharge was 3 in three cases and five cases obtained score 4. Three cases obtained GOS 5.In a 3-month clinical follow-up, one case scored modified Rankin Scale 1, three cases scored 2, four cases obtained score 3, two others scored modified Rankin Scale grade 4 and one case had modified Rankin Scale 6.Transsylvian transinsular microsurgical technique safely depicts the anatomical orientation in sylvian fissure preserving the overlying eloquent cortex in frontal and temporal lobes. This aided us to achieve better surgical and neurological outcome in patients with hypertensive deep nuclear hemorrhage irrespective to the size of hematoma.
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Strbian, Daniel, David J. Seiffge, Lorenz Breuer, et al. "Validation of the DRAGON Score in 12 Stroke Centers in Anterior and Posterior Circulation." Stroke 44, no. 10 (2013): 2718–21. http://dx.doi.org/10.1161/strokeaha.113.002033.
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Background and Purpose— The DRAGON score predicts functional outcome in the hyperacute phase of intravenous thrombolysis treatment of ischemic stroke patients. We aimed to validate the score in a large multicenter cohort in anterior and posterior circulation. Methods— Prospectively collected data of consecutive ischemic stroke patients who received intravenous thrombolysis in 12 stroke centers were merged (n=5471). We excluded patients lacking data necessary to calculate the score and patients with missing 3-month modified Rankin scale scores. The final cohort comprised 4519 eligible patients. We assessed the performance of the DRAGON score with area under the receiver operating characteristic curve in the whole cohort for both good (modified Rankin scale score, 0–2) and miserable (modified Rankin scale score, 5–6) outcomes. Results— Area under the receiver operating characteristic curve was 0.84 (0.82–0.85) for miserable outcome and 0.82 (0.80–0.83) for good outcome. Proportions of patients with good outcome were 96%, 93%, 78%, and 0% for 0 to 1, 2, 3, and 8 to 10 score points, respectively. Proportions of patients with miserable outcome were 0%, 2%, 4%, 89%, and 97% for 0 to 1, 2, 3, 8, and 9 to 10 points, respectively. When tested separately for anterior and posterior circulation, there was no difference in performance ( P =0.55); areas under the receiver operating characteristic curve were 0.84 (0.83–0.86) and 0.82 (0.78–0.87), respectively. No sex-related difference in performance was observed ( P =0.25). Conclusions— The DRAGON score showed very good performance in the large merged cohort in both anterior and posterior circulation strokes. The DRAGON score provides rapid estimation of patient prognosis and supports clinical decision-making in the hyperacute phase of stroke care (eg, when invasive add-on strategies are considered).
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Seif, Gamal I., Joshua C. Teichman, Kesava Reddy, Charmaine Martin, and Amadeo R. Rodriguez. "Incidence, Morbidity, and Mortality of Terson Syndrome in Hamilton, Ontario." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 41, no. 5 (2014): 572–76. http://dx.doi.org/10.1017/cjn.2014.7.
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AbstractObjectiveEvaluate the incidence, neurologic morbidity, and mortality of patients with Terson syndrome.MethodsConsecutive patients admitted to the Hamilton General Hospital from May 2012 to May 2013 with a diagnosis of spontaneous subarachnoid hemorrhage (SAH) were recruited. Funduscopic examinations were performed under pharmacological mydriasis. Outcome measures included: (1) the presence or absence of Terson syndrome; (2) The Glasgow Coma Scale (GCS), Hunt and Hess scale (H&H), and SAH Fisher score upon admission to the hospital; (3) the modified Rankin score upon discharge; and (4) and all-cause mortality.ResultsForty-six patients were included and 10 had Terson syndrome (21%). The median H&H, GCS, and Fisher scores were 4, 6.5, and 4.0 for patients with Terson syndrome vs. 2, 14, and 3 for patients without Terson syndrome (p=0.0032, 0.0052, and 0.031), respectively. The median Rankin score was 6 for patients with Terson syndrome vs. 3.5 for patients without Terson syndrome (p=0.0019). The odds of all-cause mortality with Terson syndrome vs. no Terson syndrome was 12: 1 (95% confidence interval 2.33-61.7), p =0.003. Only four of the 10 patients with Terson syndrome survived.ConclusionsBased on this study, approximately one-fifth of patients admitted to the hospital with a spontaneous SAH could have Terson syndrome. Patients with Terson syndrome have significantly worse GCS and H&H scores upon admission to the hospital, lower modified Rankin scores upon discharge, and greater mortality. Thus, Terson syndrome is not rare among patients with SAH and carries a worse prognosis.
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Patel, Richa D., Sidney Starkman, Scott Hamilton, et al. "The Rankin Focused Assessment—Ambulation: A Method to Score the Modified Rankin Scale with Emphasis on Walking Ability." Journal of Stroke and Cerebrovascular Diseases 25, no. 9 (2016): 2172–76. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.10.030.
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Savio, Katia, Gian Luca Della Pietra, Elodie Oddone, Monica Reggiani, and Maurizio A. Leone. "Reliability of the modified Rankin Scale applied by telephone." Neurology International 5, no. 1 (2013): 2. http://dx.doi.org/10.4081/ni.2013.e2.
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We aimed to evaluate the reliability of the modified Rankin Scale applied telephonically compared with face-to-face assessment in clinically stable hospitalized patients with acute stroke. One hundred and thirty-one patients were interviewed twice by 2 certified nurses (unstructured interview). Half of the patients were randomized to be interviewed by telephone followed by the face-to-face assessment, and half in the reverse order. The median value of the modified Rankin Scale score was 4 (first to third interquartile range 3-5) by telephone as well as by face-to-face assessment (P=0.8). The weighted kappa between the two methods was 0.82 (95% confidence interval: 0.77-0.88). Sensitivity of the telephone assessment was lower for scores 2 and 3 (17% and 46%, respectively) than for the other scores (range 67-90%). Telephone assessment of stroke disability with the modified Rankin Scale is reliable in comparison to direct face- to-face assessment.