RESUMEN

The underlying structure of National Institutes of Health Stroke Scale (NIHSS) as the most widely used scale in clinical trials has been the focus of little attention. The aim of the current study was to elucidate the clustering pattern of NIHSS items in ischemic stroke patients. A series of 152 consecutive patients with first-ever ischemic strokes admitted to a university affiliated hospital were enrolled. NIHSS score was estimated on admission and correlation coefficients between its items were calculated. Further, exploratory factor analysis was used to study the clustering pattern of NIHSS items. Extinction neglect, visual field, and facial palsy were weakly associated with other NIHSS items. Factor analysis led to a four-factor structure. Factors 1 and 3 were determined by left brain function as items of right arm and leg motor, language and dysarthria loaded on both of them. By contrast, factor 2 reflected right brain involvement. Since visual field and ataxia loaded on factor 4, this factor was primarily associated with posterior strokes. Our study shows that a four-factor structure model is plausible for NIHSS. Further, for the first time, a single distinct factor is identified for posterior strokes.

Asunto(s)

Isquemia Encefálica/diagnóstico , Evaluación de la Discapacidad , Análisis Factorial , National Institutes of Health (U.S.)/normas , Examen Neurológico/normas , Accidente Cerebrovascular/diagnóstico , Anciano , Afasia/diagnóstico , Afasia/mortalidad , Afasia/fisiopatología , Isquemia Encefálica/mortalidad , Isquemia Encefálica/fisiopatología , Infarto Cerebral/diagnóstico , Infarto Cerebral/mortalidad , Infarto Cerebral/fisiopatología , Diagnóstico Diferencial , Femenino , Lateralidad Funcional/fisiología , Humanos , Masculino , Persona de Mediana Edad , Modelos Neurológicos , Examen Neurológico/métodos , Examen Neurológico/estadística & datos numéricos , Paresia/diagnóstico , Paresia/mortalidad , Paresia/fisiopatología , Trastornos de la Percepción/diagnóstico , Trastornos de la Percepción/mortalidad , Trastornos de la Percepción/fisiopatología , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/fisiopatología , Estados Unidos , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/mortalidad , Trastornos de la Visión/fisiopatología

RESUMEN

PURPOSE: To investigate the relationship between contrast sensitivity (CS) and mortality among people with acquired immunodeficiency syndrome (AIDS); and to explore the hypothesis that abnormal CS is a marker of systemic, life-threatening microvascular disease. DESIGN: Longitudinal, observational cohort study. METHODS: We evaluated 3395 eyes of 1706 individuals enrolled in the Longitudinal Study of the Complications of AIDS (1998-2008). CS was evaluated as a risk factor for death, and was compared to the presence of systemic diseases characterized by microvasculopathy (diabetes, cardiovascular disease, stroke, renal disease) and to laboratory markers of those diseases. Abnormal CS was defined as logCS <1.5 (lower 2.5th percentile for a normal control population). RESULTS: CS was abnormal in 284 of 1691 (16.8%) study participants at enrollment. There was a positive relationship between the presence of abnormal CS at study entry and mortality (relative risk 2.0, 95% confidence interval 1.7-2.3, P < .0001). Abnormal CS was related to the presence of cardiovascular disease, stroke, and renal disease (all P values

Asunto(s)

Síndrome de Inmunodeficiencia Adquirida/mortalidad , Sensibilidad de Contraste , Trastornos de la Percepción/mortalidad , Adulto , Enfermedades Cardiovasculares/mortalidad , Causas de Muerte , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Prospectivos , Factores de Riesgo