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Brief report
Usefulness of NIHSS score as a predictor of non-neurological in-hospital complications in stroke
Utilidad del score NIHSS como predictor de complicaciones intrahospitalarias no neurológicas en ictus isquémico
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Florencia Garavelli
Corresponding author
florgaravelli@hotmail.com

Corresponding author.
, Albertina María Ghelfi, Jorge Guillermo Kilstein
Servicio de Clínica Médica, Hospital Escuela Eva Perón, Santa Fe, Argentina
Received 10 May 2020. Accepted 15 July 2020
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Table 1. Baseline characteristics of the groups.
Table 2. Multivariate analysis of the factors associated with NNIHC.
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Abstract
Introduction

Patients with stroke are at risk of developing non-neurological in-hospital complications (NNIHC) during hospitalization. The NIHSS is a scale used and validated to determine stroke severity, treatment, and prognosis. We evaluated the relationship between the NIHSS score obtained on admission and the development of NNIHC during hospital stay.

Methods

Observational study of prospective cohorts. Patients admitted consecutively for stroke, to an intermediate care ward, in Argentina between 08/01/2017 and 02/29/20 were included. The patients were divided into Group 1 (with NNIHC) and Group 2 (without NNIHC).

Results

The final n consisted of 78 individuals, 41% women. When comparing the means of the NIHSS score, differences were observed between the groups in the development of NNIHC in general (P = .050) and in the following specific complications: dysphagia (P = .014), aspiration pneumonia (P = .006), in-hospital pneumonia (P = .010) and intrahospital urinary infection (P = .004). The cut-off point of 10.5 presented the best predictive performance of NNIHC (AUC = .706; P = .016).

Conclusions

An NIHSS value ≥10.5 was related to the development of NNIHC in patients admitted for stroke.

Keywords:
Ischaemic stroke
NIHSS
In-hospital complications
Infectious complications
Dysphagia
Prediction of complications
Resumen
Introducción

Los pacientes con ictus isquémico (II) presentan riesgo de desarrollar complicaciones intrahospitalarias no neurológicas (CIHNN) durante la internación. El NIHSS es una escala utilizada y validada para determinar gravedad, tratamiento y pronóstico del II. Evaluamos la relación entre el puntaje NIHSS obtenido al ingreso y el desarrollo CIHNN durante la estancia hospitalaria.

Métodos

Estudio observacional, de cohortes prospectivas. Incluyó pacientes ingresados consecutivamente por II, en una sala de cuidados intermedios, entre 01/08/2017 y 29/02/20, en Argentina. Se dividió a los pacientes en Grupo 1 (con CIHNN) y Grupo 2 (sin CIHNN).

Resultados

La n final constó de 78 individuos; 41% mujeres. Al comparar las medias de puntaje NIHSS, se observaron diferencias entre los grupos para desarrollo de CIHNN en general (p = 0,050) y para las siguientes complicaciones específicas: disfagia (p = 0,014), neumonía aspirativa (p = 0,006), neumonía intrahospitalaria (p = 0,010) e infección urinaria intrahospitalaria (p = 0,004). El punto de corte de 10,5 presentó el mejor desempeño predictivo de CIHNN (AUC = 0,706; p = 0,016).

Conclusiones

Un valor de NIHSS ≥ 10,5 se relacionó al desarrollo de CIHNN en pacientes ingresados por II.

Palabras clave:
Ictus isquémico
NIHSS
Complicaciones intrahospitalarias
Complicaciones infecciosas
Disfagia
Predicción de complicaciones

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