Öz
Kaynakça
- 1. Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for The Primary Prevention of Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011; 42: 517–84.
- 2. Powers WJ, Derdeyn CP, Biller J, Coffey CS, Hoh BL, Jauch EC, et. al. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015; 46: 3020–35.
- 3. Chang KC, Tseng MC, Weng HH, Lin YH, Liou CW, Tan TY. Prediction of Length of Stay of First-Ever Ischemic Stroke. Stroke. 2002; 33(11): 2670-74.
- 4. İldes S, Kavalcı C, Celik K, Tekten BÖ, Kavalcı G. Cost Analysis Of Stroke Cases Admitted To Our Emergency Department In Türkiye. Наука И Здравоохранение, 2023; 25(2): 35-40.
- 5. Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular diseases III. Stroke. 1990; 21(4): 637-76.
- 6. Lyden PD, Lu M, Levine SR, Brott TG, Broderick J. NINDS rtPA Stroke Study Group. A modified National Institutes of Health Stroke Scale for Use In Stroke Clinical Trials: Preliminary Reliability And Validity. Stroke. 2001; 32(6): 1310-7.
- 7. Sulter G, Steen C, De Keyser J. Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke. 1999; 30: 1538-41.
- 8. van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver Agreement for The Assessment Of Handicap In Stroke Patients. Stroke. 1988; 19: 604-7.
- 9. Blanford, JH, Bernhofer Ch, Gay LW. Energy Flux Mechanisms Over A Pecan Orchard Oasis. Proc. 20th Conf. On Agricultural Forest Meteorology, Salt Lake City, Utah. Amer. Meteorol. Soc., Boston, MA, 1991: p. 116-119.
- 10. Razali NM, Yap BW. Power Comparisons of Shapiro-Wilk, Kolmogorov-Smirnov, Lilliefors and Anderson-Darling Tests." Journal of Statistical Modeling and Analytics 2.1, (2011): 21-33.
- 11. MacFarland TW, Yates JM. Mann–Whitney U Test. Introduction to Nonparametric Statistics for The Biological Sciences Using R. Springer International Publishing, 2016: p. 103-132.
- 12. Pratamaa D, Mulawardi M, Patrianef D. Correlation of Ankle-Brachial Index and Ultrasound Findings on Dorsalis Pedis Artery and Posterior Tibial Artery in Patients with Diabetic Foot Ulcer. Vascular, 10 (2020): 3.
- 13. Huang, Yuqin, et al. "Assessing the scale effect of urban vertical patterns on urban waterlogging: An empirical study in Shenzhen." Environmental Impact Assessment Review 106 (2024): 107486.
- 14. GBD 2019 Stroke Collaborators. Global, Regional, And National Burden Of Stroke And Its Risk Factors, 1990–2019: A Systematic Analysis For The Global Burden Of Disease Study 2019. Lancet Neurol. 2021; 20: 795-820.
- 15. World Health Organization, The top 10 causes of death [Internet]. 2025 [updated 2024 Aug 7; cited 2025 Jan 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
- 16. Feigin VL, Owolabi MO. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission. Lancet Neurol. 2023; 22:1160-1206.
- 17. GBD 2021 Stroke Risk Factor Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990–2021: A Systematic Analysis for The Global Burden of Disease Study 2021. The Lancet Neurology. 2024; 10: 1973-1003.
- 18. Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, Regional, And National Burden And Trend Of Diabetes In 195 Countries And Territories: An Analysis From 1990 To 2025. Sci Rep. 2020; 10, 14790.
- 19. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: update from the GBD 2019 Study. J Am Coll Cardiol. 2020; 76: 2982-3021.
- 20. Ying Y, Yu F, Luo Y, Feng X, Di D, Wei M, et al. Neutrophil-to-Lymphocyte Ratio as a Predictive Biomarker for Stroke Severity and Short-Term Prognosis in Acute Ischemic Stroke With Intracranial Atherosclerotic Stenosis. Front Neurol. 2021; 12: 705949.
- 21. Cummock JS, Wong KK, Volpi JJ, Wong ST. Reliability of the National Institutes of Health (NIH) Stroke Scale Between Emergency Room and Neurology Physicians for Initial Stroke Severity Scoring. Cureus. 2023; 14; e37595.
- 22. Yoshimura S, Sakai N, Yamagami H, Uchida K, Beppu M, Toyoda K, et al. Endovascular Therapy for Acute Stroke with a Large Ischemic Region. N Engl J Med. 2022; 386: 1303-13.
Öz
Stroke is the second leading cause of death and the third leading cause of disability worldwide with a global prevalence estimated at 0.2% . It also significantly contributes to healthcare costs. Ischemic strokes, which result from disrupted cerebral blood flow, make up approximately 80–85% of all stroke cases. Key risk factors for stroke include hypertension, diabetes mellitus, heart disease, hyperlipidemia, smoking, and lifestyle factors. This study investigated the impact of stroke risk factors and lesion localization on stroke severity, as measured by the NIHSS scale, and patient independence at discharge, as evaluated by the Modified Rankin Scale (MRS). The analysis included 159 patients, comprising 82 women (51.6%) and 77 men (48.4%), with a mean age of 68.1±14.2 years, 93.1% of whom were over 45 years old. Stroke types were distributed as follows: 41.5% anterior circulation, 37.1% posterior circulation, and 21.4% lacunar strokes.
The factors affecting the difference between NIHSS values (Delta NIHSS) at admission and discharge were analyzed by univariate and multivariate analysis methods. According to the results of univariate analysis, the presence of hypertension, myocardial infarction, coronary artery and carotid disease, previous insulin use, intravenous-tPA (iv-tPA), intra-arterial-tPA (ia-tPA) and thrombectomy treatments, age, NLR, mean blood pressure and exit MRS values were significantly associated with Delta NIHSS (p<0.05). Multivariate analysis revealed a positive correlation between Delta (∆) NIHSS value and CAD and iv-tPA values and a negative correlation with exit MRS value (p=0.021; p=0.012 and p<0.001 respectively). Our model provides consistent results for the relationship between NIHSS and MRS scores and positive and negative functional outcomes.
Anahtar Kelimeler
Stroke NIHSS Score Shapiro-Wilk Test Mann-Whitney U Test Spearman Rho Test Regression Analysis
Kaynakça
- 1. Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for The Primary Prevention of Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011; 42: 517–84.
- 2. Powers WJ, Derdeyn CP, Biller J, Coffey CS, Hoh BL, Jauch EC, et. al. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015; 46: 3020–35.
- 3. Chang KC, Tseng MC, Weng HH, Lin YH, Liou CW, Tan TY. Prediction of Length of Stay of First-Ever Ischemic Stroke. Stroke. 2002; 33(11): 2670-74.
- 4. İldes S, Kavalcı C, Celik K, Tekten BÖ, Kavalcı G. Cost Analysis Of Stroke Cases Admitted To Our Emergency Department In Türkiye. Наука И Здравоохранение, 2023; 25(2): 35-40.
- 5. Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular diseases III. Stroke. 1990; 21(4): 637-76.
- 6. Lyden PD, Lu M, Levine SR, Brott TG, Broderick J. NINDS rtPA Stroke Study Group. A modified National Institutes of Health Stroke Scale for Use In Stroke Clinical Trials: Preliminary Reliability And Validity. Stroke. 2001; 32(6): 1310-7.
- 7. Sulter G, Steen C, De Keyser J. Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke. 1999; 30: 1538-41.
- 8. van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver Agreement for The Assessment Of Handicap In Stroke Patients. Stroke. 1988; 19: 604-7.
- 9. Blanford, JH, Bernhofer Ch, Gay LW. Energy Flux Mechanisms Over A Pecan Orchard Oasis. Proc. 20th Conf. On Agricultural Forest Meteorology, Salt Lake City, Utah. Amer. Meteorol. Soc., Boston, MA, 1991: p. 116-119.
- 10. Razali NM, Yap BW. Power Comparisons of Shapiro-Wilk, Kolmogorov-Smirnov, Lilliefors and Anderson-Darling Tests." Journal of Statistical Modeling and Analytics 2.1, (2011): 21-33.
- 11. MacFarland TW, Yates JM. Mann–Whitney U Test. Introduction to Nonparametric Statistics for The Biological Sciences Using R. Springer International Publishing, 2016: p. 103-132.
- 12. Pratamaa D, Mulawardi M, Patrianef D. Correlation of Ankle-Brachial Index and Ultrasound Findings on Dorsalis Pedis Artery and Posterior Tibial Artery in Patients with Diabetic Foot Ulcer. Vascular, 10 (2020): 3.
- 13. Huang, Yuqin, et al. "Assessing the scale effect of urban vertical patterns on urban waterlogging: An empirical study in Shenzhen." Environmental Impact Assessment Review 106 (2024): 107486.
- 14. GBD 2019 Stroke Collaborators. Global, Regional, And National Burden Of Stroke And Its Risk Factors, 1990–2019: A Systematic Analysis For The Global Burden Of Disease Study 2019. Lancet Neurol. 2021; 20: 795-820.
- 15. World Health Organization, The top 10 causes of death [Internet]. 2025 [updated 2024 Aug 7; cited 2025 Jan 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
- 16. Feigin VL, Owolabi MO. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission. Lancet Neurol. 2023; 22:1160-1206.
- 17. GBD 2021 Stroke Risk Factor Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990–2021: A Systematic Analysis for The Global Burden of Disease Study 2021. The Lancet Neurology. 2024; 10: 1973-1003.
- 18. Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, Regional, And National Burden And Trend Of Diabetes In 195 Countries And Territories: An Analysis From 1990 To 2025. Sci Rep. 2020; 10, 14790.
- 19. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: update from the GBD 2019 Study. J Am Coll Cardiol. 2020; 76: 2982-3021.
- 20. Ying Y, Yu F, Luo Y, Feng X, Di D, Wei M, et al. Neutrophil-to-Lymphocyte Ratio as a Predictive Biomarker for Stroke Severity and Short-Term Prognosis in Acute Ischemic Stroke With Intracranial Atherosclerotic Stenosis. Front Neurol. 2021; 12: 705949.
- 21. Cummock JS, Wong KK, Volpi JJ, Wong ST. Reliability of the National Institutes of Health (NIH) Stroke Scale Between Emergency Room and Neurology Physicians for Initial Stroke Severity Scoring. Cureus. 2023; 14; e37595.
- 22. Yoshimura S, Sakai N, Yamagami H, Uchida K, Beppu M, Toyoda K, et al. Endovascular Therapy for Acute Stroke with a Large Ischemic Region. N Engl J Med. 2022; 386: 1303-13.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Nöroloji ve Nöromüsküler Hastalıklar |
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Mart 2025 |
| Gönderilme Tarihi | 20 Ocak 2025 |
| Kabul Tarihi | 25 Mart 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 42 Sayı: 1 |
Kaynak Göster
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.