Predicting the immediate outcome of patients with cerebrovascular accident: a prognostic score.

ABSTRACT

A prognostic score was derived from a prospective study of 120 consecutive patients with cerebrovascular accident. Multivariate analysis was used to compare the presenting clinical features of 106 (88%) of these patients with their immediate outcome (survival or death). Similar analysis was also used to compare features on CT scan with immediate outcome in 45 patients. The immediate prognostic features included old age, history of previous stroke, mental obtundation at the onset, persistent altered consciousness greater than or equal to first 48 hours, altered consciousness appearing in the first 24-72 hours, complete hemiplegia, seizures, aspiration pneumonitis, and multiple/massive lesions and gross mass effect on CT scan. The prognostic score derived from discriminant function using CT scan variables was less accurate than that formulated from only clinical variables. In the latter (using clinical variables) a prognostic score of 46 or less suggested a 50% chance of recovery, scores of 47 or more a 50% chance of death, while scores of 12 or less and 63 or more suggested a 99% likelihood of survival and death respectively.