Ischemic stroke

NIH Stroke Scale (NIHSS)
Completion of an NIHSS for all ischemic stroke patients is a Neurocritical Care Society Clinical Performance Measure.

Additional therapies
Various additional therapies have been consider for the management of acute ischemic stroke that are not yet standard of care. These include:
 * Induced hypertension
 * Neuroprotection
 * Targeted temperature management

Seizures
In one large series of 86,550 with stroke (73,887 ischemic stroke and 12,474 intraparenchymal hemorrhage), late seizures (more than 7 days after stroke onset) occurred in 8.4% of patients with ischemic or hemorrhagic stroke.

Risk factors include:
 * Male sex
 * Intraparenchymal hemorrhage
 * Higher NIHSS
 * First degree relative with epilepsy (HR 1.18, 95% CI 1.09-1.28)

Imaging

 * Small vessel disease → greater presence associated with worsened outcomes
 * Atrophy → greater presence associated with worsened outcomes

Patient characteristics

 * Alcohol withdrawal → higher likelihood of in-hospital complications including UTI (aOR 1.56, 95% CI 1.39-1.74), pneumonia (aOR 2.04, 95% CI 1.77-2.35), sepsis (aOR 1.79, 95% CI 1.48-2.17), DVT (aOR 1.58, 95C CI 1.22-2.04), gastrointestinal hemorrhage (aOR 1.57, 95% CI 1.26-1.96), MI (aOR 1.43, 95% CI 1.17-1.78), and acute renal failure (aOR 1.57, 95% CI 1.40-1.76). Furthermore it is associated with a higher odds of mortality (aOR 1.32, 95% CI 1.11-1.54), a lower odds of home disposition (aOR 0.53, 95% CI 0.49-0.58). Length of stay was on average 15 days longer in patients with alcohol withdrawal, and the cost of hospitalization was on average $5,000 more.
 * Chronic kidney disease (GFR <60 mL/minute per 1.73 m2) → presence associated with worsened likelihood of independence after thrombectomy (aOR 0.53, 95% CI 0.29-0.96). and increased likelihood of recurrent stroke (aHR 2.56, 95% CI 1.27-5.18).

GWTG Stroke score (2013)
This score as derived and validated from an extremely large sample of over 300,000 stroke patients (all types) from the Get With the Guidelines - Stroke Database. It included 274,988 patients with ischemic stroke, for which the AUROC for mortality was 0.84.