Background And Purpose: The simplified modified Rankin Scale questionnaire (smRSq) enables a reliable and rapid determination of the modified Rankin Scale score after stroke. We test the reliability and validity of a slightly revised smRSq.
Methods: Fifty consecutive outpatients 4.83 ± 3.00 months after stroke were scored with a slightly revised smRSq by 3 raters selected consecutively from a list of 10: 4 stroke faculty, 3 neurology residents, 2 medial students, and 1 stroke research coordinator. Two ratings were in person within 20 minutes of each other and 1 was by telephone 1 to 3 days later. The telephone rating also included a quality of life scale, the Short-Form-12v2. Each rater was blinded to the other raters' scores.
Results: The average estimated time to administer the smRSq was 1.29 minutes (range, 0.50 to 2.25 minutes). The in-person raters agreed 78% (κ=0.71; CI, 0.57 to 0.86 and weighted κ [κ(w)]=0.86; CI, 0.79 to 0.94). The first in-person and telephone raters agreed 82% (κ=0.76; CI, 0.63 to 0.90 and κ(w)=0.87; CI, 0.79 to 0.95). The second in-person and telephone rates agreed 82% (κ=0.77; CI, 0.63 to 0.90 and κ(w)=0.89; CI, 0.82 to 0.96). The smRSq correlated with the physical (r=-0.50, P=0.005) than the mental (r=-0.36, P=0.048) components of the Short-Form-12v2.
Conclusions: The slightly revised smRSq appears to be useful in clinical stroke; it has excellent reliability in person and by telephone, can usually be administered in <1.5 minutes by a wide variety of raters, and correlates with quality of life.
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http://dx.doi.org/10.1161/STROKEAHA.111.613273 | DOI Listing |
JAMA Netw Open
January 2025
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Importance: Nelonemdaz selectively antagonizes the 2B subunit of the N-methyl-d-aspartate glutamate receptor and scavenges free radical species.
Objective: To evaluate whether nelonemdaz enhances the clinical outcomes of patients with acute ischemic stroke undergoing emergent reperfusion therapy.
Design, Setting, And Participants: This multicenter double-blind placebo-controlled randomized phase 3 trial (December 25, 2021, to June 30, 2023, in South Korea) recruited patients with acute ischemic stroke who met the following criteria: National Institutes of Health Stroke Scale score greater than or equal to 8, Alberta Stroke Program Early Computed Tomography score greater than or equal to 4, and endovascular thrombectomy within 12 hours after stroke onset.
Health Qual Life Outcomes
January 2025
Department of Nursing, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic.
Background: The relationship between social support and functional outcomes and health-related quality of life (HRQoL) after ischemic stroke (IS) remains unclear, especially in working-aged patients.
Aim: To assess the relationship between perceived social support, functional outcomes, post-stroke psychosocial symptoms, and HRQoL in working-aged adults three months after IS.
Methods: A prospective and correlational design was used.
Neurology
February 2025
Department of Neurology, Department of Stroke, University Hospital Cleveland Medical Center, Case Western Reserve University, Cleveland, OH.
Background And Objectives: Although previous trials have established the efficacy and safety of endovascular thrombectomy (EVT) in large ischemic core strokes, most of them excluded patients with extracranial internal carotid artery (e-ICA) occlusion. We aimed to compare outcomes in patients with e-ICA occlusion and large ischemic core infarcts treated with EVT vs medical management (MM).
Methods: This was a secondary analysis of the SELECT2 trial, a randomized controlled trial conducted at 31 international sites.
JAMA Neurol
January 2025
Department of Neurology, UAB Heersink School of Medicine, University of Alabama at Birmingham, Birmingham.
Importance: In the Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke (ARCADIA) randomized clinical trial, anticoagulation did not prevent recurrent stroke among patients with a recent cryptogenic stroke and atrial cardiopathy. It is unknown whether anticoagulation prevents covert infarcts in this population.
Objective: To test the use of apixaban vs aspirin for prevention of nonlacunar covert infarcts after cryptogenic stroke in patients with atrial cardiopathy.
J Am Coll Surg
January 2025
University of Florida Health, Division of Cardiovascular Surgery, Department of Surgery, Gainesville, Florida USA.
Background: The purpose of this study is to evaluate the clinical outcomes of patients undergoing a simpler (hemiarch) vs complex (zone 2 arch) aortic repair for acute type A aortic dissection (TAAD).
Methods: Adults (≥18 years) who underwent hemiarch or zone 2 arch repair for acute, hyperacute, or acute on chronic TAAD at a single institution between January 2018 and April 2024 were reviewed. Disabling stroke was defined as modified Rankin scale ≥4.
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