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Stroke severity, its correlates and impact on thrombolysis in a population-based study
P A Lyrer1, F Fluri, M Gostynski
1Neurological Clinic and Stroke Unit, University Hospital Basel, Basel, Switzerland. plyrer@uhbs.ch
European Neurology
|August 13, 2009
Summary
One-third of stroke patients experience moderate to severe strokes. Public awareness campaigns should target younger individuals, emphasizing that even mild strokes require prompt medical attention for better outcomes.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Stroke severity distribution and correlates are not well-documented in population-based studies.
- Understanding stroke severity is crucial for resource allocation and public health initiatives.
Purpose of the Study:
- To determine the distribution of stroke severity using the NIH Stroke Scale Score (NIHSSS).
- To investigate associations between NIHSSS and demographic factors, stroke unit care, stroke etiology, onset-to-assessment interval (OAI), and thrombolysis rates.
Main Methods:
- Post-hoc analysis of a prospective, population-based stroke study in Basel City, Switzerland.
- Data from 188,015 residents were analyzed, focusing on NIHSSS in 246/269 patients.
- Statistical methods included univariate and multivariate regression analyses.
Main Results:
- The median NIHSSS was 5.0 +/- 6.0, with 14% of patients having NIHSSS >15 (moderate-to-severe stroke).
- Higher NIHSSS correlated with older age, female gender, stroke unit treatment, cardioembolic etiology, shorter OAI, and thrombolysis.
- Multivariate analysis confirmed independent associations of age, OAI, and thrombolysis with NIHSSS.
Conclusions:
- Approximately one-third of the studied stroke population experienced moderate-to-severe strokes.
- Patients with milder strokes were younger, had longer OAI, and received less thrombolysis.
- Public stroke awareness programs should include younger demographics and emphasize timely emergency care for all stroke severities.
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