Sains Malaysiana 49(5)(2020): 1115-1120

http://dx.doi.org/10.17576/jsm-2020-4905-16

Correlation between Alberta Stroke Programme Early Computed Tomography Score (ASPECTS) and National Institute of Health Stroke Score (NIHSS) in Ischemic Stroke

(Korelasi antara Skor Awal Tomografi Berkomputer Program Strok Alberta (ASPECTS) dan Skor Strok Institut Kesihatan Nasional (NIHSS) pada Strok Iskemik)

LISDA AMALIA¹*, MARDA ARIF FURQANI¹, IDA PARWATI², AHMAD RIZAL¹ & RAMDAN PANIGORO³

¹Department of Neurology, University of Padjadjaran/Hasan Sadikin, General Hospital Bandung, Indonesia

²Department of Clinical Pathology, University of Padjadjaran/Hasan Sadikin, General Hospital Bandung, Indonesia

³Department of Basic Medical Science, University of Padjadjaran/Hasan Sadikin, General Hospital Bandung, Indonesia

Received: 17 September 2018/Accepted: 21 January 2020

ABSTRACT

Computed tomography scanning (CT-scan) hold an important role in diagnosing ischemic stroke, but may find difficulties to assess an early ischemic changes. ASPECTS provide a tool for assessing CT-scan in ischemic stroke, which can be used as predictor of stroke outcome. Stroke outcome and severity can also be assessed using NIHSS. We hypothesize that ASPECT score had negative correlation with neurological deficit in patient with acute ischemic stroke compared with non-contrast head CT scan. This was an analytic-descriptive cross-sectional study on first-onset ischemic stroke patient in Neurology Ward of Hasan Sadikin General Hospital admitted from October 2017 – February 2018. ASPECTS was calculated from CT-scan of ischemic stroke patients involving medial cerebral artery and compared to NIHSS. From 58 subject (44.8% male, 55.2%) female), with mean age 56.60+ 9.1 years, there were 58.6% subject with lacunar stroke, 20.7% with large artery atherosclerotic (LAA) stroke, and 20.7% with cardioemboli stroke. Subjects with LAA stroke and lacunar stroke had higher ASPECTS (p value < 0.05) and had lower NIHSS (p value < 0.05) than subjects with cardioembolic stroke. Spearman’s correlation test between ASPECTS and NIHSS show a strong correlation between ASPECTS and NIHSS (r=-0.680, p<0.001). There was a strong inverse correlation between ASPECTS and NIHSS score on acute ischemic stroke. The higher the value of ASPECTS, the lower the value will be for NIHSS and ASPECT score had correlation with stroke severity.

Keywords: ASPECTS; ischemic stroke; NIHSS

ABSTRAK

Pengimbasan tomografi berkomputer (skan CT) memainkan peranan penting dalam mendiagnosis strok iskemia, tetapi mungkin menghadapi kesukaran untuk menilai perubahan awal iskemia. ASPECTS menyediakan alat untuk menilai skan CT pada strok iskemia, yang boleh digunakan sebagai peramal kesan strok. Kesan dan keparahan strok juga dapat dinilai menggunakan NIHSS. Kami membuat hipotesis bahawa skor ASPECT mempunyai korelasi negatif dengan defisit neurologi pada pesakit dengan strok iskemia akut berbanding dengan skan CT kepala tanpa kontras. Ini adalah kajian keratan rentas analitik-deskriptif pada pesakit strok iskemia pertama di Wad Neurologi Hospital Umum Hasan Sadikin yang diterima dari Oktober 2017 - Februari 2018. ASPECTS dihitung daripada skan CT pesakit strok iskemia yang melibatkan arteri serebrum medial dan dibandingkan kepada NIHSS. Daripada 58 subjek (44.8% lelaki, 55.2%) wanita), dengan min usia 56.60+ 9.1 tahun, terdapat 58.6% subjek dengan strok lakunar, 20.7% dengan strok aterosklerotik arteri besar (LAA) dan 20.7% dengan strok kardioemboli. Subjek dengan strok LAA dan lakunar mempunyai ASPECTS yang lebih tinggi (nilai p <0,05) dan mempunyai NIHSS yang lebih rendah (nilai p <0,05) daripada subjek dengan strok kardioemboli. Ujian korelasi Spearman antara ASPECTS dan NIHSS menunjukkan korelasi yang kuat antara ASPECTS dan NIHSS (r = -0.680, p <0.001). Terdapat korelasi berbalik yang kuat antara skor ASPECTS dan NIHSS pada strok iskemia akut. Semakin tinggi nilai ASPECTS, semakin rendah nilainya untuk NIHSS dan skor ASPECT mempunyai hubungan dengan keparahan strok.

Kata kunci: ASPECTS; NIHSS; strok iskemia

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*Corresponding author; email: dr.lisda@gmail.com