The Rasch Model Applied across the Human Sciences
Trevor G. Bond, Zi Yan, Moritz Heene in Applying the Rasch Model, 2020
When we learn that the Stroke Council of the American Heart Association recommended the use of the National Institutes of Health Stroke Scale (NIHSS) for assessing acute stroke and for the evaluation of neurologic impairment after stroke, the efforts of Millis, Straube, Iramaneerat, Smith, and Lyden (2007) to assess its psychometric properties seem well grounded. Although expert opinion was involved in the selection of the 15 NIHSS items on the basis of the empirical literature, some of those items have been subsequently shown to be unreliable, redundant, or not related to the underlying latent trait. Recommendations to shorten the instrument have been confounded by factor analyses results suggesting two (rather than one) underlying constructs representing left and right functions—depending on the location of the patient’s lesion. The risk for patient care and treatment derives from the possibility that the same NIHSS score might have different implications, depending on the lesion location (right v. left cerebral hemisphere).
Stroke
Henry J. Woodford in Essential Geriatrics, 2022
The National Institutes of Health Stroke Scale (NHISS – see Appendix A) is used to rate stroke severity. Typically, very severe strokes (scores of 25 or above) are considered inappropriate for thrombolysis due to higher risk of adverse outcome. Also, mild strokes (scores < 5) are often excluded on the basis that risks may exceed possible functional gains, although an exception might be made for isolated aphasia (as it would have a large functional impact).
Stroke
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor in Manual of Neuroanesthesia, 2017
Relevant history must include the following: Time of onset of symptoms3 or last seen normal.History of comorbidities including hypertension, diabetes, ischemic heart disease, which also cause AIS.History of alcohol abuse, liver disease. Anticoagulant use and atrial fibrillation must be sought, which predispose the patient to hemorrhagic stroke.NIHSS (National Institutes of Health Stroke Scale), which focuses on the level of consciousness, focal neurologic deficits, and speech abnormalities. Higher NIHSS scores have been shown to be associated with a worse outcome.Computed tomography (CT)/magnetic resonance imaging (MRI) findings, particularly arterial territory involved.12-lead ECG (arrhythmias especially atrial fibrillation).Neurological status including NIHSS score.Sex, ethnicity.Serum glucose.Complete blood count, platelet countInternational normalized ratio (INR), prothrombin time, partial thromboplastin time.Baseline serum electrolytes and creatinine to assess renal function.Weight.Age.Allergies to iodinated contrast medium.Contraindications to MRI.Administration of IV tPA and total dose given.Patient's medication list, if available.
The relationship between first pass recanalization of stent-retriever-based thrombectomy and neutrophil to lymphocyte ratio in middle cerebral artery occlusions
Published in International Journal of Neuroscience, 2021
Stroke severity assessments were based on the National Institutes of Health Stroke Scale (NIHSS). According to a previous studies, we defined moderate to severe stroke as patients with NIHSS ≥ 10. The complete revascularization of the large vessel occlusion and its downstream territory was measured with Modified Thrombolysis in Cerebral Infarction (mTICI) scale with no use of rescue therapy. The favorable outcome at the end of therapy is consistent with patients that were treated with first pass thrombectomy, defined as mTICI score 2b, 2c or 3. The primary functional outcome was measured at 3 months after stroke onset using the modified Rankin scale (mRS, scores range from 0 to 6). The favorable clinical outcome was defined with the mRS scores 0 to 3 at 90 days. In addition, mortality rates of the patients at the end of the third month were examined.
Long-term trajectories of community integration: identification, characterization, and prediction using inpatient rehabilitation variables
Published in Topics in Stroke Rehabilitation, 2023
Alejandro Garcia-Rudolph, Joan Sauri, Katryna Cisek, John D. Kelleher, Vince Istvan Madai, Dietmar Frey, Eloy Opisso, Josep María Tormos, Montserrat Bernabeu
All patients admitted to the rehabilitation unit are referred from different acute care setting hospitals and fulfill the hospital criteria for admission, which include SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) objectives30 and support for discharge in case of severe disability. The rehabilitation program includes 5 h of intensive treatment oriented toward cognitive, swallowing, behavioral, and physical problems as well as training in activities of daily life living. Variables related to the rehabilitation program such as the time in between onset of injury and initiation of the rehabilitation program (Time from onset to Admission (days)) and length of stay (LOS) were also reported. At hospital admission, stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Medical complications and comorbidities were collected from the participants’ electronic health records. The following were included: aphasia, diabetes, dyslipidemia, dysphagia, hypertension, atrial fibrillation, neglect, affected side, dominance, educational level, smoking habits.
A scoping review of psychoeducational interventions for people after transient ischemic attack and minor stroke
Published in Topics in Stroke Rehabilitation, 2021
Eirini Kontou, Jade Kettlewell, Laura Condon, Shirley Thomas, Abigail R. Lee, Nikola Sprigg, Dame Caroline Watkins, Marion F. Walker, Farhad Shokraneh
Although all studies state that they included TIA and/or minor stoke participants, the definition of diagnoses was variable and, in some cases unclear. The diagnosis of minor/mild stoke across the studies was (i) National Institutes of Health Stroke Scale (NIHSS) score of ≥1, 0 to 5, ≤3, or ≤15; (ii) score >8.5/11.5 on the Canadian Neurological Scale; (iii) a modified Rankin Score between 0 and 2; (iv) Barthel Index score of >60 or ≥65; (v) minor stroke confirmed by positive findings on CT or MRI of the head. There was no common definition of minor stroke, and no explicit definition of TIA. The number of participants with a TIA versus minor stroke diagnosis was not clearly reported in one study24 and three studies included both diagnoses but did not report the numbers.23,25,26
Related Knowledge Centers
- Amputation
- Cerebral Hemisphere
- Conjugate Gaze Palsy
- Stupor
- Stroke
- Basal Ganglia
- Dysarthria
- Aphasia
- Injury
- Intubation