Abstract T P257: Analysis for Usefulness of Worsen Score; the Predicting Score for the Deterioration of Acute Ischemic Stroke
Introduction: One third of patients with acute ischemic stroke develop early neurological worsening, a situation associated with increased mortality and long-term functional disability. It is important to prevent patients with acute ischemic stroke from deteriorating. We made WORSEN score for predicting factors in deteriorating stroke within 1 week from onset, and investigated its usefulness.
Methods: At first, we retrospectively investigated 537 patients who were admitted to Juntendo University Hospital within 2 days of the occurrence of an acute ischemic stroke, between April 2007 and March 2009. Deterioration of neurological findings was defined as the worsening of 4 points or more on the National Institute of Health Stroke Scale (NIHSS) score during admission to the hospital within 1 week. After logistic regression analysis, we made WORSEN score, and scoring those patients. Second, we investigated this score for another 453 patients who admitted Juntendo University Hospital and Juntendo Urayasu hospital between April 2010 and June 2014.
Result: Out of 537 patients, deterioration was noted in 64 patients (11.9%; deterioration group). After multivariate analysis, we set WORSEN score as follows; W; wrong blood sugar control (HbA1c (NGSP) >7.4%), O; old myocardial infarction, R; radiological findings; ICA-MCA M1 proximal occlusion, striate-capsular infarction, pontine infarction S; size of infarct (15-30mm), E; elevated LDL-cholesterol (>140mg/dl), N; neurological findings; NIHSS>8 at onset, and each factor set scored as 1 point. Next, we checked WORSEN score in those group, deterioration was noted in 35% at score 3, 57% at score 4 and 100% at score 5. Finally, in another 453 patients group, deterioration was detected in 74% over 3 points.
Conclusion: It is important to predict deterioration in patients with minor ischemic stroke and those with many risk factors for deterioration should be given the best possible treatment. To careful attention should be paid to acute stroke patients with high WORSEN score, this scale might become one of an important tool for detect neurological deterioration of ischemic stroke.
Author Disclosures: N. Miyamoto: None. R. Tanaka: None. Y. Ueno: None. M. Watanabe: None. Y. Tanaka: None. Y. Shimada: None. T. Kuroki: None. K. Yamashiro: None. N. Hattori: None. T. Urabe: None.
- © 2015 by American Heart Association, Inc.