NIHSS cut-point for predicting outcome in supra- vs infra-tentorial acute ischemic stroke

Objective: To determine the optimal cut-point on the National Institutes of Health Stroke Scale (NIHSS) for predicting poor 90-day clinical outcome in patients with supra- and infra-tentorial acute ischemic stroke (AIS).
Methods: Data are from participants of the alteplase-dose arm of the randomised controlled trial, Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Associations between baseline characteristics of clinically-defined supratentorial and infratentorial AIS patients and poor functional outcome, defined by scores 3-6 on the modified Rankin scale (mRS), were evaluated in logistic regression models, with area under curve (AUC) receiver operating characteristics defining the optimal NIHSS predictor cut-point.
Results: Patients with infratentorial AIS (n=289) had lower baseline NIHSS scores than those with supratentorial AIS (n=2613) (median 7 vs 9; p <0.001). NIHSS cut-point for poor outcome were 10 (AUC 76, sensitivity 65%, specificity 73%) an...