Seybou Hassane Diallo*, Gurkan Mutlu, Ange E. Kouamé Assouan, Youssoufa Maiga, Anne Leger; Sandrine Deltour, Sophie Crosier, Charlotte Rosso, Christine Pires, Yves Samson
Strokes are common and represent a major public health concern in both industrialized countries and developing countries. Patient management must prevent overcrowding of intensive care beds and downstream bed capacity.
The aim of the study was to propose an early discharge strategy from the stroke unit after IV thrombolysis, based primarily on the NIHSS score. This is a retrospective study involving 617 patients admitted to the neurovascular unit the "Pitié-Salpêtrière" hospital for ischemic stroke, divided into two cohorts, March 2010 and August 2012.
The patients were divided into 4 classes according to the NIHSS score: Class A, B, C, and D. They were clinically assessed on day 1 and day 7, considering as a criterion for worsening the transition from a lower to a higher class. Patients in classes A and D who were candidates for early discharge worsened less than patients in classes B and C. This study demonstrated that it is indeed possible to stratify patients using the NIHSS score as early as 24 hours after IV thrombolysis into groups at high risk of deterioration and groups at lower risk of deterioration. The least severe patients in class A and the most severe in class D could be discharged 24 hours after thrombolysis, while those in classes B and C needed to stay in neurovascular ICU unit for more than 24 hours.
This stratification at the early discharge from neurovascular ICU, if implemented, could have a positive impact on the organization of ICU, especially in low-income countries.
Published Date: 2025-01-27; Received Date: 2025-11-20
