Evidence map›Paper›PMID 41475420›Full record

ArticleAnnals of medicine2026

Discharge NIHSS scores are predictive of poor 3-month outcomes in patients with acute Ischemic stroke receiving intravenous thrombolysis.

Longhai Zhu, Yan Qin, Tingting Kang, Yaoyu Ying, Yongjun Cao, Jijun Shi

Abstract read
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Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Longhai ZhuDepartment of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.ORCID 0009-0006-5447-4705
Yan QinDepartment of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Tingting KangDepartment of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Yaoyu YingDepartment of Medical Affairs, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Yongjun CaoDepartment of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.ORCID 0000-0002-8135-8914
Jijun ShiDepartment of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.ORCID 0000-0003-3852-3993

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeWhile early National Institutes of Health Stroke Scale (NIHSS) scores are predictive of outcomes in patients with acute ischemic stroke (AIS), the prognostic value of the discharge NIHSS score after intravenous thrombolysis (IVT) remains unclear. We aimed to determine whether the discharge NIHSS score outperforms baseline, 24-hour, and early change indicators in predicting poor 3-month outcomes (modified Rankin scale [mRS] score of 3-6).

methodsIn this retrospective cohort study, we analyzed 554 AIS patients who received IVT at our stroke center from May 2022 to March 2024. NIHSS scores were assessed at baseline, 24 h, and discharge. Absolute (baseline minus discharge) and percentage (absolute change/baseline × 100%) NIHSS changes were calculated. Multivariable logistic regression analyses were used to assess the independent correlation between different NIHSS scores and poor outcomes. Predictive performance was evaluated using receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

resultsDischarge NIHSS scores demonstrated superior discriminative ability for poor outcomes (AUC 0.950, 95% CI 0.932-0.969) versus baseline (AUC 0.842), 24-hour (AUC 0.930), absolute change (AUC 0.689), and percentage change (AUC 0.885) (all

conclusionsThis study revealed a notable association between the discharge NIHSS score and poor 3-month outcomes in thrombolysis-eligible patients with AIS, particularly in those with moderate stroke severity. These findings complement the established prognostic value of the 24-hour NIHSS score and may guide postacute care planning.

Indexed as

Fibrinolytic AgentsIschemic StrokePatient DischargeThrombolytic TherapyAdministration, IntravenousAgedAged, 80 and overFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisRetrospective StudiesROC CurveSeverity of Illness IndexFibrinolytic AgentsTissue Plasminogen Activatorfunctional outcomeintravenous thrombolysisIschemic strokeNIHSS scoreprognosis

Identifiers

PMID41475420
PMCPMC12777931

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