Views: 2,373 | Downloads:
558
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Establishment of the Thai version of National Institute of Health Stroke Scale (NIHSS) and a Validation Study
Nilanont Y 
,
Phattharayuttawat S ,
Chiewit P ,
Chotikanuchit S ,
Limsriwilai J ,
Chalernpong L ,
Yamkaew N ,
Lirathpong N ,
Anprasertporn P ,
Komoltri C ,
Prayoonwiwat N ,
Poungvarin N
,
Phattharayuttawat S ,
Chiewit P ,
Chotikanuchit S ,
Limsriwilai J ,
Chalernpong L ,
Yamkaew N ,
Lirathpong N ,
Anprasertporn P ,
Komoltri C ,
Prayoonwiwat N ,
Poungvarin N Background: The National Institute of Health Stroke Scale (NIHSS) is a well validated stroke severity assessment
scale. The scale is used to assess neurological deficits, progression and degree of recovery in acute
stroke settings. To date, no Thai version exists.
Objective: This study aimed to adapt and validate a Thai version of the NIHSS (NIHSS-T).
Material and Method: A cross-cultural adaptation of the NIHSS was developed according to the methods
recommended by the International Quality of Life Assessment Project Group. Forward and backward
translations were performed. A final version of the NIHSS-T was validated against initial MRI infarction
volume and modified Rankin Scale (mRS) at 3 months in a consecutive series of acute stroke patients. The
patients were prospectively evaluated by 3 different types of health care providers: 2 stroke fellows, 2 internists,
and 2 stroke nurses. Mean NIHSS-T scores from all raters were used in the analysis.
Results: The study included 32 acute ischemic stroke patients with a mean age (+ SD) of 64.53 + 14.97 years
of age. Men comprised 71.9%. Mean NIHSS-T score (+ SD) was 7.49 + 7.02. Intra-observer reliability demonstrated
a high agreement with an intraclass correlation (ICC) of 0.98, 0.98, 0.96, 0.98, 0.90 and 0.98 for 2
stroke fellows, 2 internists and 2 stroke nurses respectively. Inter-observer reliability between 6 raters was
excellent, i.e.; ICC, 0.99 (0.98, 0.99). Spearman rank correlation coefficients between the initial NIHSS-T
score versus initial MRI lesion volume and mRS at 3 months were 0.53 and 0.69 with a p-value of 0.002 and <
0.001 respectively.
Conclusion: The Thai version of NIHSS is valid for assessing acute stroke severity. The scale is also reliable
when administered in a Thai-speaking setting by trained healthcare professionals.
Keywords: National Institute of Health Stroke Scale (NIHSS), Thai version, Stroke severity assessment, Neurological
scales
scale. The scale is used to assess neurological deficits, progression and degree of recovery in acute
stroke settings. To date, no Thai version exists.
Objective: This study aimed to adapt and validate a Thai version of the NIHSS (NIHSS-T).
Material and Method: A cross-cultural adaptation of the NIHSS was developed according to the methods
recommended by the International Quality of Life Assessment Project Group. Forward and backward
translations were performed. A final version of the NIHSS-T was validated against initial MRI infarction
volume and modified Rankin Scale (mRS) at 3 months in a consecutive series of acute stroke patients. The
patients were prospectively evaluated by 3 different types of health care providers: 2 stroke fellows, 2 internists,
and 2 stroke nurses. Mean NIHSS-T scores from all raters were used in the analysis.
Results: The study included 32 acute ischemic stroke patients with a mean age (+ SD) of 64.53 + 14.97 years
of age. Men comprised 71.9%. Mean NIHSS-T score (+ SD) was 7.49 + 7.02. Intra-observer reliability demonstrated
a high agreement with an intraclass correlation (ICC) of 0.98, 0.98, 0.96, 0.98, 0.90 and 0.98 for 2
stroke fellows, 2 internists and 2 stroke nurses respectively. Inter-observer reliability between 6 raters was
excellent, i.e.; ICC, 0.99 (0.98, 0.99). Spearman rank correlation coefficients between the initial NIHSS-T
score versus initial MRI lesion volume and mRS at 3 months were 0.53 and 0.69 with a p-value of 0.002 and <
0.001 respectively.
Conclusion: The Thai version of NIHSS is valid for assessing acute stroke severity. The scale is also reliable
when administered in a Thai-speaking setting by trained healthcare professionals.
Keywords: National Institute of Health Stroke Scale (NIHSS), Thai version, Stroke severity assessment, Neurological
scales
Download:
PDF