The Scandinavian stroke scale predicts outcome in patients with mild ischemic stroke

BACKGROUND: The prognostic value of the Scandinavian Stroke Scale (SSS) in patients with mild ischemic stroke has not previously been examined. We investigated if differences in SSS score predicted risk of death or dependency within 12 months after stroke onset. PATIENTS AND METHODS: The analysis included 353 patients with acute cerebral infarction and SSS of at least 40 points on admission, 157 of whom with SSS of at least 50 points. Patients with 40-49 points on the SSS were compared with patients with 50-58 points; and patients with SSS 50-53 were compared to patients with 54-58 points on the SSS. Death or dependency was defined as 3-6 points on the modified Rankin scale (MRS), 3 and 12 months after stroke onset. The frequencies of death or dependency were compared between groups by chi2; the risk of death or dependency 1 year after stroke was calculated by multiple logistic regression analysis, adjusting for age, gender, prestroke MRS, arterial hypertension and tobacco smoking. RESULTS: The risk of death or dependency 1 year after stroke onset was higher in patients with SSS 40-49 than with SSS 50-58, OR 2.0 (CI 95% 1.2-3.5). Three months after stroke, 46.5% of patients with SSS 40-49 were dead or dependent in comparison with 23.9% of patients with SSS > 49, p < 0.001. One year after stroke, 53.6% of patients with SSS 40-49 were dead or dependent in comparison with 30.1% of patients with SSS > 49, p <0.001. A significant 15% difference in living in own home was observed 1 year after stroke onset between patients with SSS 40-49 and SSS > 49. In very mild stroke, 32.7% of patients with SSS 50-53 were dead or dependent 3 months after stroke in comparison with 18.1% of patients with SSS 54-58 on admission, p = 0.048. CONCLUSIONS: The SSS predicts death and dependence in patients with mild ischemic stroke.