Diagnostic Accuracy of NIHSS Score in Predicting in-Hospital Mortality in Patients of Ischemic Stroke taking Actual in-Hospital Mortality as Gold Standard

Abstract

Abstract: Objective: To determine the diagnostic accuracy of NIHSS score for predicting in-hospital mortality among patients of ischemic stroke taking in-hospital mortality as gold standard. Material & Methods: The present cross-sectional study was carried out from May 2020 to November 2020 at Medicine Department, Services Institute of Medical Sciences Lahore. A total of 142 patients aged 30-70 years of both sex with ischemic stroke patients as per-operational definition of duration ?24 hours were enrolled. Patients of hemorrhagic stroke, cardiac disease and CRF were excluded. After taking informed consent, NIHSS score was evaluated in each patient and in hospital mortality will be noted. All patients were followed by the researcher herself and in hospital mortality was noted. Results: Mean age was 53.5+9.2 years with74 (52.11%) females. Mean disease duration was 6.8+1.7 hours and mean NIHSS score was 24.3+7.1. NIHSS score was evaluated in each patient and found 75 True Positive while 06 False Positive. In the 61 NIHSS score negative patients, in-hospital mortality was seen in 06 (False Negative) while 55 (True Negative) did not have in-hospital mortality (p-value <0.001). The Specificity, Sensitivity, Negative Predictive Value (NPV), Positive Predictive Value (PPV) and diagnostic accuracy of NIHSS score to predict in-hospital mortality among patients of ischemic stroke taking in-hospital mortality as gold standard was 92.59%, 90.16%, 92.59%, 90.16% and 91.55% respectively. Conclusion: Diagnostic accuracy of NIHSS score in predicting in-hospital mortality in ischemic stroke patients is quite high.