Analysis Of Correlation Between NIHSS Score And Large Vessel Occlusion In Anterior Circulation Of Acute Ischemic Stroke

Objective To investigate the predictive value of NIHSS score for anterior circulation large vascular occlusion in acute ischemic stroke and to determine the best cut-off point.Methods Patients with acute anterior circulation ischemic stroke who were hospitalized in Department of Neurology in our hospital,from January 2014 to july 2018 were enrolled in this retrospective study,and the time window was within 6 hours.According to Computed Tomography angiography(CTA),patients were divided into two groups: artery occlusion group(n=31)and non-artery occlusion group(n=82).Then according to the time window,the two groups were divided into two groups: 3h and 3-6h respectively.After admission,the patients were scoreded with NIHSS,the operating curve(ROC)was drawn,and the area under the curve was calculated to evaluate the predictive value of NIHSS score in patients with acute ischemic stroke and determined the optimal cut-off point.Results A total of 113 patients were included in the study,including 31 patients in the occlusion group,the mean NIHSS score of the occlusion group < 3 hours was 11.75 ±6.13,the mean NIHSS score of the occlusion group 3-6 hours was 11.09 ±6.79.The mean NIHSS score of the non-occlusion group < 3 hours was 6.29 ±3.30,the mean NIHSS score of the non-occlusion group 3-6 hours was 5.63 ±3.43.The NIHSS score in the occlusion group was significantly higher than that in the non-occlusion group,which was statistically significant(P < 0.05).There was no significant difference in baseline data(age、sex、hypertension、diabetes、hyperlipidemia、ischemic heart disease、atrial fibrillation、smoking,、 drinking、history of stroke or TIA history)between the two groups(P > 0.05).The ROC curve showed that the area under the ROC curve was 0.772(P < 0.05),the sensitivity was 89.1%,and the specificity was 60%.The best truncation point was 9.5.The area under the ROC curve was 0.771(P < 0.05),the sensitivity was 85.2%,the specificity was 72.7% and the best cut-off point was 8.5.Conclusion NIHSS score is valuable in predicting anterior circulation major vascular occlusion in acute ischemic stroke.The best cut-off point of time window is 9.5 when time window is < 3 hours and the best cut-off Point of time window is 8.5 in 3-6 hours.