Measurement of Short-Term Functional Outcome Using Modified Rankin Scale in Patients With Acute Ischaemic Stroke
Author(s)
Bettina Kovács, MSc1, Luca F. Kajos, MSc1, Dalma Pónusz-Kovács, MSc1, László Szapáry, MD, Ph.D., Habil2, Eszter Jozifek, MSc2, Patricia Szántóri, MSc3, Imre Boncz, MSc, PhD, MD1;
1University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Pécs, Hungary, 2University of Pécs, Clinical Centre, Department of Neurology, Pécs, Hungary, 3University of Pécs, Faculty of Health Sciences, Institute of Human Nutrition and Dietetics, Pécs, Hungary
1University of Pécs, Faculty of Health Sciences, Institute for Health Insurance, Pécs, Hungary, 2University of Pécs, Clinical Centre, Department of Neurology, Pécs, Hungary, 3University of Pécs, Faculty of Health Sciences, Institute of Human Nutrition and Dietetics, Pécs, Hungary
Presentation Documents
OBJECTIVES: The modified Rankin Scale (mRS) has been the gold standard for measuring stroke outcome in clinical trials for many years. This study aimed to assess the functional outcome of acute ischaemic stroke patients using the Modified Rankin Scale (mRS) 30 days post-stroke.
METHODS: The study was conducted at the Neurology Clinic of the University of Pécs Clinical Centre, where acute ischaemic stroke patients admitted between June 2022 and May 2023 were selected via convenience sampling. Patients were grouped into intravenous thrombolysis (IVT), mechanical thrombectomy (MT), and standard care (SC) based on treatments received. The 30-day follow-up assessed stroke severity using the NIH Stroke Scale (NIHSS) and functional outcome with the Modified Rankin Scale (Pre-mRS, follow-up mRS). Statistical analyses included descriptive statistics, paired T-tests, Wilcoxon tests, and McNemar tests (SPSS 25.0; p <0.05).
RESULTS: A total of 198 patients (115 men, 83 women) participated (MT: 50, IVT: 69, SC: 79). Significant NIHSS score improvements were observed in all groups (IVT: 4.36 vs. 1.57, p<0.001; MT: 8.98 vs. 4.50, p<0.001; SC: 4.38 vs. 2.84, p<0.001). Most patients in all groups were in the mild mRS category (0-2) at Pre-mRS (88%, 176 patients) and follow-up mRS (80%, 158 patients).
CONCLUSIONS: The slight deterioration in mRS values in the MT and SC groups can be attributed to several factors. Limitations in daily activities are not always evident during early rehabilitation after stroke, which may hinder recovery. In addition, when patients return home and receive less assistance, minor changes in functional abilities become more apparent, which may lead to changes in mRS categories. Age-related deterioration in health, progression of underlying diseases and psychosocial factors such as depression and fatigue may play a role in the deterioration. Further research is needed to better understand changes in mRS and to optimise stroke rehabilitation.
METHODS: The study was conducted at the Neurology Clinic of the University of Pécs Clinical Centre, where acute ischaemic stroke patients admitted between June 2022 and May 2023 were selected via convenience sampling. Patients were grouped into intravenous thrombolysis (IVT), mechanical thrombectomy (MT), and standard care (SC) based on treatments received. The 30-day follow-up assessed stroke severity using the NIH Stroke Scale (NIHSS) and functional outcome with the Modified Rankin Scale (Pre-mRS, follow-up mRS). Statistical analyses included descriptive statistics, paired T-tests, Wilcoxon tests, and McNemar tests (SPSS 25.0; p <0.05).
RESULTS: A total of 198 patients (115 men, 83 women) participated (MT: 50, IVT: 69, SC: 79). Significant NIHSS score improvements were observed in all groups (IVT: 4.36 vs. 1.57, p<0.001; MT: 8.98 vs. 4.50, p<0.001; SC: 4.38 vs. 2.84, p<0.001). Most patients in all groups were in the mild mRS category (0-2) at Pre-mRS (88%, 176 patients) and follow-up mRS (80%, 158 patients).
CONCLUSIONS: The slight deterioration in mRS values in the MT and SC groups can be attributed to several factors. Limitations in daily activities are not always evident during early rehabilitation after stroke, which may hinder recovery. In addition, when patients return home and receive less assistance, minor changes in functional abilities become more apparent, which may lead to changes in mRS categories. Age-related deterioration in health, progression of underlying diseases and psychosocial factors such as depression and fatigue may play a role in the deterioration. Further research is needed to better understand changes in mRS and to optimise stroke rehabilitation.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR159
Topic
Patient-Centered Research
Topic Subcategory
Patient Behavior and Incentives, Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)