By Dr. Kevin Maloy, April 2015
We ran across the NINDS data in an appendix to A Graphic Reanalysis of the NINDS Trial (Ann Emerg Med 2009; 54(3):329-36) and thought it was a gold mine of interesting data.
Hoping to better see the natural history of stroke, we came up with one nice visualization of the data. Since it is animated, we cannot submit it. But if you would like the check it out, you can on YouTube. It uses patients who had no neurological deficit before their stroke (approx 550) and follows their NIH Stroke Scale (NIHSS) at a few different data points. You can see each patient get worse or better throughout the study (at one day after stroke, 7-10 days after stroke, and 90 days after stroke). The y axis is the baseline NIHSS severity of stroke, while the x axis is the NIHSS severity of stroke over time. At twenty four hours, the severity of stroke appears to be all over the board, however, at 90 days, patients tend to get better (move to the left) or succumb (move to the right with an NIHSS of 42).
[Kevin Maloy is an Emergency Medicine physician, a Clinical Infomaticist and Coder. He teaches the Hacking Healthcare selective at Georgetown University School of Medicine. Learn more about Kevin here: http://mi2.org/about/mi2-leaders/kevin-maloy]