Predicting the outcome of acute stroke: a prognostic score

A prognostic score was derived from a prospective study of 148 consecutively admitted patients, aged less than 76 years, who survived the first 24 hours after an acute stroke. Multivariate analysis was used to compare the presenting clinical features of 137 (93%) of these patients with their outcome after two months. Little change in the level of residual disability was detected in 128 of these patients after a further four months. The features which were found to predict functional dependence or death included older age, complete limb paralysis, depression of conscious level and the combination of hemiplegia and hemianopia with higher cerebral dysfunction. Hemiparesis uncomplicated by hemianopia or higher cerebral dysfunction predicted a return to functional independence. A discriminant function derived from this analysis can be used to calculate the likelihood of recovery to independent function for an individual patient following an acute stroke.