Predicting 90-day modified Rankin Scale score with discharge information in acute ischaemic stroke patients following treatment

• Authors: Andrew K Elhabr, Georgia Institute of Technology; Jeffrey M Katz, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell; Jason Wang, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell; Mehrad Bastani, Feinstein Institute for Medical Research; Gabriela Martinez, Siemens USA; Michele Gribko, North Shore University Hospital; Danny Hughes, Emory University; Pina Sanelli, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
• Journal Title: BMJ Neurology Open
• Volume: Volume 3, Number 1
• Publisher: BMJ | 2021-06-24, Pages e000177-e000177
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1136/bmjno-2021-000177
• Subjects: Health Sciences, Radiology
• Keywords: stroke

Abstract

Objectives To understand variability in modified Rankin Scale scores from discharge to 90 days in acute ischaemic stroke patients following treatment, and examine prediction of 90-day modified Rankin Scale score by using discharge modified Rankin Scale and discharge disposition. Materials and methods Retrospective analysis of acute ischaemic stroke patients following treatment was performed from January 2016 to March 2020. Data collection included demographic and clinical characteristics and outcomes data (modified Rankin Scale score at discharge, 30 days and 90 days and discharge disposition). Pearson's χ 2 test assessed statistical differences in distribution of modified Rankin Scale scores at discharge, 30 days and 90 days. The predictive power of discharge modified Rankin Scale score and disposition quantified the association with 90-day outcome. Results A total of 280 acute ischaemic stroke patients (65.4% aged ≥65 years, 47.1% female, 60.7% white) were included in the analysis. The modified Rankin Scale score significantly changed between 30 and 90 days from discharge (p<0.001) after remaining stable from discharge to 30 days (p=0.665). The positive and negative predictive values of an unfavourable long-term outcome for discharge modified Rankin Scale scores of 3-5 were 67.7% (95% CI 60.4% to 75.0%) and 82.0% (95% CI 75.1% to 88.8%), and for non-home discharge disposition were 72.4% (95% CI 64.5% to 80.2%) and 74.5% (95% CI 67.8% to 81.3%), respectively. Conclusions Discharge modified Rankin Scale score and non-home discharge disposition are good individual predictors of 90-day modified Rankin Scale score for ischaemic stroke patients following treatment.