Journal of Stroke 2015;17(1):38-53 http://dx.doi.org/10.5853/jos.2015.17.1.38
On page 47, the definition of stroke progression was erroneously described in the previous version of article, and the correct definition of “stroke progression” is as following;
Corrected Table 5
Table 5.
Definitions of outcome variables in the CRCS-5 registry
| Outcome variables | Definitions | Operational definitions |
|---|---|---|
| END Collected since January 2011 | Any new neurological symptoms/signs or neurological worsening within 3 weeks of index stroke | Any of the following; |
| Causes of END | 1) Increase in total NIHSS score ≥ 232 | |
| • Recurrent stroke | 2) Increase in NIHSS subscores 1a, 1b, or 1c (level of consciousness) ≥ 133 | |
| • Stroke progression | 3) Increase in NIHSS subscores 5a, 5b, 6a, or 6b (motor) ≥ 132 | |
| • Symptomatic hemorrhagic transformation | 4) Any new neurological deficit (even unmeasurable by NIHSS scores)32 | |
| • Others (deep vein thrombosis, pulmonary embolism, myocardial infarction, etc.) | ||
| • Unknown | ||
| Recurrent stroke for END (within 3 weeks of index stroke)30,32 | Development of END associated with new lesions docu- mented by relevant neuroimaging study | • Discrete new lesions documented by diffusion-weighted image or computed tomography |
| • If discrete, new lesions within the vascular territory of the index stroke lesion may be counted | ||
| • Do not count for increased volume of the index stroke lesions | ||
| • Donotcountforedema,masseffect,herniation,or hemorrhagic transformation of the index stroke lesions | ||
| Recurrent stroke (late recurrence ≥ 3 weeks following index stroke)29,31,34-36 | Rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than of vascular origin37 | Data collected through face-to-face or telephone inter- view with the patient or next of kin |
| Question: Were you diagnosed with ischemic stroke or hemorrhagic stroke by any doctor after discharge? | ||
| Stroke progression32 | END event in neurologically stable patients ≥ 24 hours | |
| • May be attributable to peri-lesional edema | ||
| • For cases with ≤ 24 hours after onset, END events not attributable to recurrent stroke | ||
| Symptomatic hemorrhagic transformation32 | END events attributable to documented hemorrhagic transformation and associated with NIHSS score increase ≥ 4 points | |
| Other causes of END | END events attributable to medical conditions (e.g., deep vein thrombosis, pulmonary embolization, pneumonia, etc.) | |
| Unknown causes of END | END events not specified above | |
| Myocardial infarction | For END events (≤ 3 weeks after index stroke, more than two from below; | |
| • Typicalchestpain | ||
| • Troponin elevation | ||
| • ECG changes (new ST segment changes, new Q wave, or new left bundle branch block) | ||
| For long-term outcomes (≥ 3 weeks after index stroke), data collected through face-to-face or telephone interview with the patient or next of kin | ||
| • Question: Were you diagnosed with myocardial infarction by any doctors after discharge? | ||
| Vascular death | Death due to stroke, myocardial infarction, or sudden death38,39 | Data collected through face-to-face or telephone interview with the patient or next of kin |
| • No known non-atherosclerotic cause and definite MI or stroke within 4 weeks before death40 | ||
| • No known non-atherosclerotic cause and one or both of the following: chest pain within 72 hours of death or a history of chronic ischemic heart disease (in the absence of valvular heart disease or non-ischemic cardiomyopathy)40 | ||
| • No known non-atherosclerotic cause and death certificate consistent with CHD as underlying cause40 | ||
| Non-vascular death | Death not attributable to stroke, myocardial infarction, or sudden death40 | Data collected through face-to-face or telephone interview with the patient or next of kin |
END, early neurological deterioration; NIHSS, National Institute of Health Stroke Scale; ECG, electrocardiography; MI, myocardial infarction; CHD, coronary heart disease.
END event in neurologically stable patients ≥ 24 hours
• May be attributable to peri-lesional edema
• For cases with ≤ 24 hours after onset, END events not attributable to recurrent stroke