Abstract 2173: Abbreviated 7-Item NIHSS for Inpatient Acute Stroke Management
Background: Each year, nearly 800,000 people experience a new or recurrent stroke. To assess changes in neurological status during hospitalization, nurses are required to complete the 15-item National Institute of Health Stroke Scale (NIHSS), which is time consuming and therefore, may not be completed as thoroughly as it should. To ensure these patients are being effectively and adequately assessed, there is a need for an abbreviated NIHSS, which can be completed in a shorter time frame. Purpose: The purpose of this study was to determine the merits of an abbreviated NIHSS using seven items considered to be key to determining changes in neurological status.
Methods: Over a six month period, 100 scores from the 15-item NIHSS were collected on a sample of 92 acute care stroke patients who had a mean age of 64.2; 52% were female. Seven items were calculated, which included level of consciousness, left and right arm motor movement, left and right leg motor movement, speech fluency, and speech clarity. To assess internal consistency reliability of the 7-item NIHSS, Cronbach's α was computed. To assess criterion validity, the 7-item NIHSS and 15-item NIHSS were correlated using Pearson's r.
Results: The 15-item NIHSS ranged from 1 to 37, with a mean of 8.6. The 7-item NIHSS ranged from 0 to 24, with a mean of 4.9. For the 7-item NIHSS, Cronbach's α was .82 and Pearson's r was .96 (p<.001), when correlated with the 15-item NIHSS.
Conclusions: Assessment of the acute stroke patient using the 15-item NIHSS is time-consuming, and therefore, may be underutilized. An abbreviated 7-item NIHSS demonstrated satisfactory evidence of internal consistency reliability and criterion validity, when correlated with the 15-item NIHSS, suggesting the 7-item version may be a suitable alternative to the longer version. More psychometric testing is warranted to fully evaluate reliability and validity of the 7-item NIHSS.
- © 2012 by American Heart Association, Inc.