Abstract: Objective To explore the clinical significance of WORSEN score in predicting early neurological deterioration (END) in acute Ischemic stroke (AIS) patients. Methods The clinical data of 402 patients with AIS were retrospectively collected from neurology department of one tertiary grade A hospital by convenient sampling method from January 2014 to December 2017. The first validation group (group 1) consisted of 300 patients from January 2014 to December 2016, and the second validation group (group 2) 102 patients from January to December 2017. Patients were evaluated by using National Institutes of Health Stroke Scale (NIHSS) within 24h of admission and the laboratory and imaging examination results were evaluated by using WORSEN score for admitted patients. The incidence of early neurological deterioration was recorded. According to the Receiver Operating Characteristic Curve (ROC), Area under the ROC Curve (AUC), Youden index, sensitivity and specificity, the value of WORSEN score in predicting END was assessed. Results WORSEN score was positively correlated with the incidence of END（r=0.424,P<0.001） and the higher the score, the greater probability of the END. The score of patients in the 2 groups fluctuated between 0 to 7 and when WORSEN score was 3, The Youden index was the best, which was the best cut-off point to predict the occurrence of END. In group 1, the AUC of the predicted END was 0.778 (95%CI: 0.710~0.845), with a sensitivity of 68.0%, specificity of 76.8%, accuracy of 75.3%, positive predictive value of 37.0% and negative predictive value of 92.3%, and it had good fitting degree with group 2 (χ²=7.000, P=0.321). Conclusion WORSEN score has good prediction value for the occurrence of END, which can be used as an assessment tool for clinical medical staff to judge the progress of AIS patients.

Key words: acute ischemic stroke, early neurological deterioration, warning model, warning score, predictive factor