PREDICTION OF FUNCTIONAL OUTCOME AND TISSUE LOSS IN ACUTE CORTICAL INFARCTION

Objective: To compare the acute Alien's Prognostic Score, Canadian Neu rological Score, and subacute Barthel Index as predictors of outcome f unctional status and infarct size at 3 months in patients with acute c ortical infarction. Design: A prospective study of acute stroke predic tors and outcome measurements in a cohort of sequential hospitalized p atients. Patients: Fifty-one patients with acute cortical infarction a nd without previous disability assessed 24 hours after onset with Alie n's Prognostic Score and the Canadian Neurological Score and at 7 days with the Barthel Index. Main Outcome Measures: Mortality, Barthel Ind ex, and volumetric measurement of infarct size on computed tomography 3 months after stroke. Results: There were seven deaths. The outcome B arthel Index was measured in all 44 survivors, of whom 29 had computed tomography at the time outcome was determined. In a multivariate anal ysis, functional outcome was best predicted by Alien's Prognostic Scor e, a score of less than -15 having a sensitivity of 82% and specificit y of 97% in predicting a poor outcome (Barthel Index, less than or equ al to 12 or death). Volumetric tissue loss was predicted only by Alien 's Prognostic Score (r=.62, P<.001). Conclusions: Alien's Prognostic S core is a robust predictor of both functional outcome and tissue loss in acute cortical infarction and has a potentially important role in t he analysis of the results of acute stroke intervention trials.