Original ArticleDefining Mild Stroke: Outcomes Analysis of Treated and Untreated Mild Stroke Patients
Section snippets
Methods
This analysis included review of all adult acute ischemic stroke patients from a prospective registry of consecutive stroke code patients (the University of California San Diego Specialized Programs of Translational Research in Acute Stroke (SPOTRIAS) database, 2003-2014) with 90-day modified Rankin Scale (mRS) score available who could be classified as “mild” by various definitions. Stroke codes are routinely called on patients presenting within 12 hours of onset of neurologic deficit.
Results
There were 802 acute ischemic stroke patients included in our database who had 90-day mRS scores available. These patients did not represent mimics or transient ischemic attacks; after analysis of the clinical course and imaging, multiple stroke practitioners determined them to be ischemic strokes. This consensus was reached at a weekly stroke team meeting during which all aspects of the case were presented. When analysis was limited to baseline mRS of 0 (analyses 1 and 2), we identified 276
Discussion
Using both definitions of mild stroke (either simply NIHSS 0-5 or the TREAT-derived definition) we were unable to convincingly show a difference in outcomes in treated versus untreated mild stroke patients. In addition, we did not show a difference in outcomes based on the definition used. Regardless of treatment being given, or which definition was used, 25%-30% of patients did not have good functional outcome at 90 days. This emphasizes the current equipoise for efficacy of intravenous rtPA
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Cited by (0)
B.C.M. was supported by an NIH grant: P50N5044148 (UCSD). The University of Cincinnati Department of Neurology iis paid for P.K.'s research efforts by Penumbra (THERAPY Trial Neuro PI), Genentech (PRISMS Trial PI), and Biogen (DSMB Member).