Evaluación de la sensibilidad y especificidad de la escala E-NIHSS versus NIHSS como predictor de la evolución desfavorable a tres meses en pacientes con accidente cerebrovascular isquémico de circulación posterior en el Hospital General IESS Ceibos Norte, periodo 2022-2023.

Abstract

Introduction: Ischemic stroke (ICA) is a significant cause of mortality and disability globally. In Ecuador, it represents the third leading cause of death, and posterior circulation stroke accounts for 20% of cases. Evaluating predictive tools is crucial to improve the prognosis of these patients. This study aims to evaluate the sensitivity and specificity of the Expanded-NIHSS scale (E-NIHSS) as a predictor of unfavorable outcome at 3 months in patients with posterior circulation stroke. Methodology: An observational, longitudinal, retrospective and prospective study was conducted at the Hospital General IESS Ceibos (2022-2023). We included 366 patients diagnosed with posterior circulation stroke, confirmed by CT or MRI. Data were analyzed using IBM- SPSS Statistics 25, considering as unfavorable outcome a score on the modified Rankin scale ≥ 3. Results: We analyzed 366 patients, with a mean age of 68 years. The E-NIHSS showed greater sensitivity (76.6%) than the NIHSS (39.1%) in predicting unfavorable outcomes at 3 months, although with lower specificity (74.1% vs. 89.7%). E-NIHSS had a better negative predictive value (74% vs. 57%). Conclusions: E-NIHSS proved to be more effective than traditional NIHSS in predicting unfavorable outcomes in patients with posterior circulation MI, presenting higher sensitivity and negative predictive value. However, the generalization of the results may be limited by the homogeneity of the population studied.