Sapsosnik et al reported the Stroke Prognostication using Age and NIHSS (SPAN) index in patients undergoing intravenous thrombolysis for ischemic stroke. This is a simple method of distinguishing low and high risk groups. The authors are from the University of Toronto, University of San Diego, Michigan State University, Medical University of South Carolina, and the University of San Francisco.


Patient selection: intravenous thrombolysis with tissue plasminogen activator for ischemic stroke


Outcome: Intracerebral hemorrhage (ICH) is defined as hemorrhage within the first 36 hours after therapy. It is considered symptomatic if there is a decline in neurologic status. A composite favorable outcome at 3 monmths was a modified Rankin Scale <=1 , NIHSS <= 1, Barthel Index >= 95, and Glasgow Outcome Scale 1.



(1) age in years

(2) NIHSS on admission


SPAN index =

= (age in years) + (NIHSS)



• An index < 100 is SPAN-100 negative.

• An index >= 100 is SPAN-100 positive.

• A negative SPAN-100 index was associated with a higher rate of favorable composite outcome at 3 months.

• A positive SPAN-100 index was associated with a higher rate of intracerebral hemorrhage.



• The area under the ROC curve is 0.73 for symptomatic ICH and 0.64 for favorable composite outcome.


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