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May 1995

Prediction of Functional Outcome and Tissue Loss in Acute Cortical Infarction

Author Affiliations

From the University Departments of Medicine (Drs Chua, Davis, Infeld, and Hopper and Mr Rossiter), Radiology (Dr Tress), and Neurology (Drs Chua, Davis, and Infeld and Mr Rossiter), the Royal Melbourne Hospital, Victoria, Australia.

Arch Neurol. 1995;52(5):496-500. doi:10.1001/archneur.1995.00540290086022

Objective:  To compare the acute Allen's Prognostic Score, Canadian Neurological Score, and subacute Barthel Index as predictors of outcome functional status and infarct size at 3 months in patients with acute cortical infarction.

Design:  A prospective study of acute stroke predictors and outcome measurements in a cohort of sequential hospitalized patients.

Patients:  Fifty-one patients with acute cortical infarction and without previous disability assessed 24 hours after onset with Allen's Prognostic Score and the Canadian Neurological Score and at 7 days with the Barthel Index.

Main Outcome Measures:  Mortality, Barthel Index, and volumetric measurement of infarct size on computed tomography 3 months after stroke.

Results:  There were seven deaths. The outcome Barthel Index was measured in all 44 survivors, of whom 29 had computed tomography at the time outcome was determined. In a multivariate analysis, functional outcome was best predicted by Allen's Prognostic Score, a score of less than −15 having a sensitivity of 82% and specificity of 97% in predicting a poor outcome (Barthel Index, ≤12 or death). Volumetric tissue loss was predicted only by Allen's Prognostic Score (r=.62, P<.001).

Conclusions:  Allen's Prognostic Score is a robust predictor of both functional outcome and tissue loss in acute cortical infarction and has a potentially important role in the analysis of the results of acute stroke intervention trials.