Day-90 acute ischemic stroke outcomes can be derived from early functional activity level

Area of Science:

• Neurology
• Clinical Neuroscience
• Stroke Medicine

Background:

• The standard assessment for functional outcome after acute ischemic stroke is typically at 3 months.
• Early prognostic indicators are crucial for patient anxiety, managing follow-up, and optimizing clinical trial designs.

Purpose of the Study:

• To determine if functional outcome at 7-10 days post-stroke can reliably predict the 90-day functional outcome.
• To identify early predictors of stroke recovery.

Main Methods:

• Analysis of the NINDS-tPA Study database.
• Global disability assessed using the modified Rankin Scale (mRS).
• Spearman correlation and weighted kappa agreement (unadjusted and adjusted) used to evaluate the association between early and 90-day mRS scores.

Main Results:

• A strong correlation (r=0.81) and high agreement (kappa=0.82) were found between mRS scores at day 7/10 and day 90.
• Early mRS was an independent predictor of 90-day mRS.
• Baseline NIH Stroke Scale and congestive heart failure history also influenced 90-day outcomes.

Conclusions:

• Functional status one week after ischemic stroke is a strong predictor of final 3-month disability.
• Early functional assessment, combined with stroke severity and CHF history, can guide patient and family counseling.