Computerized tomography head scans as predictors of functional outcome of stroke patients

Preadmission computerized tomography (CT) scans of the head were used to help develop a clinical method for the prediction of outcome of stroke patients. The functional gains and discharge outcomes of 100 stroke patients after inpatient rehabilitation were considered. Reports of preadmission (acute care hospital) CT scans of the head were analyzed and placed into six groups representing progressive anatomic involvement. Functional status was measured at admission and discharge using the patient evaluation and conference system (PECS) and placed into four functional groups. The groups ranged from normal to totally dependent in self-care activities, ambulation, and bladder and bowel functioning. Admission CT head scans reported in two categories--"normal" or "small superficial infarct"--were associated with return to independent functioning. Bihemispheric infarcts were associated with discharge to nursing home (71%), rather than to independent living. Of all patients with functional gain as measured with PECS, 79% returned home.