Association of stroke severity and early neurological deterioration in patients with acute ischemic stroke


  • Laddawan Pensri Walailak University School of Nursing
  • Sineenart Naksri Walailak University School of Nursing


early neurologic deterioration, acute ischemic stroke, stroke severity


The purpose of this predictive correlational study was to examine the association of stroke severity and early neurologic deterioration (END) in patients with acute ischemic stroke. The study was conducted based on the concept of symptom management. Sample were secondary data from medical records of patients with acute ischemic stroke receiving treatment in Hatyai hospital, Songkhla province from October 2011 to February 2016. There were 3,110 cases being selected based on the inclusion criteria. Data were collected using Stroke severity composed of the National Institute of Health Stroke Scale, Glasgow Coma Scale, modified Rankin Scale, and Barthel index. The data was analyzed using Chi-Square and Logistic regression statistics, using 95% confidence level.

The results revealed that the overall rate of END was 7.96. The NIHSS, GCS, mRS, BI, age, smoking, drinking alcohol were able to predict END. In the all factor-adjusted model, we found that more END occurred among patients with mild to moderate NIHSS score than those with severe NIHSS score (OR 1.69; 95% CI 1.09-2.62), mild to moderate GCS than severe GCS (OR 14.52; 95% CI 9.24-22.83), mild to moderate mRS than severe mRS (OR 2.41; 95% CI 1.65-3.52. Whereas, the BI scores were not different, between patients with and without END.

The results of this research can be used to guide stroke care using NIHSS, GCS, mRS to monitor the occurrence of early neurologic deterioration (END) and provide immediate care. This will contribute to a decrease in the rate of serious complications.


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How to Cite

Pensri L, Naksri S. Association of stroke severity and early neurological deterioration in patients with acute ischemic stroke. Thai J. Cardio-Thorac Nurs. [Internet]. 2022 Mar. 12 [cited 2024 Apr. 15];32(2):146-60. Available from:



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