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New Tool Helps Predict Stroke Patient's Risk of Death in Hospital: Study
Date:9/27/2010

is accurate even without the NIHSS score.

"In our case, it (the mathematical calculation) indicates that the predictions are pretty accurate and probably clinically useful," said Smith.

Relying on the NIHSS score at admission isn't feasible because "the time needed to perform even a short standardized stroke severity assessment is probably a barrier to more widespread use," according to the study.

The overall in-hospital death rate from stroke was 5.5 percent, the researchers found.

Aside from severity of stroke, the strongest predictors of death in the hospital were older age, being female, weekend or evening admission, and arrival by ambulance, which could indicate more severe stroke symptoms. Co-existing illnesses, such as atrial fibrillation (irregular heart beat), previous heart attack, vascular disease and diabetes, were also significant predictors of death.

The study only included patients with ischemic stroke, the more common and less serious type. Ischemic stroke results from a disruption in blood flow to the brain and accounts for 85 percent of strokes. It is not known if the findings would apply to hemorrhagic stroke, which results from bleeding in the brain and carries a 25 percent rate of in-hospital deaths.

Dr. Roger Bonomo, director of the stroke center at Lenox Hill Hospital in New York City, said his hospital participates in the GWTG-Stroke program, and the hope is that the study will eventually help doctors improve survival rates from stroke.

For now, he added, it represents "a work in progress."

"Stroke is a significant cause of death and it's going to continue to be," said Bonomo. This data will be good for "seeing if we're making a difference in the outcomes, changing the natural history of death that would be expected from strokes," he added.

More information

For stroke risk factors and prevention tips, visit the

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