Stroke size correlates with functional outcome on the simplified modified Rankin Scale questionnaire

Acute stroke size is one of the factors impacting functional outcome. To further validate the simplified modified Rankin Scale questionnaire (smRSq), we tested its correlation with stroke size.

We screened 60 ischemic stroke patients with acute brain images available for stroke volume measurement who were enrolled in 2 smRSq reliability studies. Inclusion criteria were acute ischemic stroke visible on computed tomography (CT) or magnetic resonance imaging (MRI) and the smRSq scored at least 3 months after stroke. We excluded patients with disabilities from a previous stroke. One investigator who was blinded to the functional outcomes measured stroke volumes with a specialized computer program (Analyze). We used MRI when both MRI and CT were available. We classified strokes into 2 size categories: lacunar type measuring ≤ 6.28 cm(3), which corresponds to a cylinder with a maximum diameter and height of 2.00 cm, or strokes >6.28 cm(3). The Spearman correlation analysis compared the smRSq between the lacunar type and the larger strokes.

Thirty-two patients qualified for this analysis with a mean age of 59 ± 15 years, and 17 (53%) were men. Lacunar stroke volumes (n = 17) ranged from 0.03 to 4.58 cm(3), and the larger stroke volumes (n = 15) ranged from 11.52 to 250.02 cm(3). Lacunar strokes were associated with lower smRSq scores (median 1) than the larger strokes (median 4; r = 0.68; R(2) = 0.46; P < .001).

Acute stroke size correlates well with the smRSq, supporting its validity in assessing functional outcome after stroke.