title: The role of prognostic scores in targeting stroke rehabilitation in elderly patients.
abstract: OBJECTIVE
  To determine the validity of clinically derived prognostic scores in targeting stroke rehabilitation in elderly patients.
  
  
  METHODS
  One-year prospective cohort study in 96 hospitalized stroke patients over 75 years of age from a well defined geographical area.
  
  
  METHODS
  Edinburgh prognostic score (incorporating measures of motor deficit, proprioception, and power), Orpington prognostic score (Edinburgh score modified to include a measure of cognition), and Barthel ADL scores were measured at 1, 2, and 4 weeks after stroke. These scores were correlated with outcome and patients' Barthel ADL score at discharge or at 16 weeks if still in hospital.
  
  
  RESULTS
  Edinburgh prognostic score measured at 2 weeks correlated significantly with Barthel ADL score at discharge or at 16 weeks (r2 = 0.57, P < 0.001), and Orpington prognostic scores showed greater correlation (r2 = 0.89 vs 0.57), especially in patients with dementia (r2 = 0.81 vs 0.39). Barthel ADL scores at 2 weeks showed a weak correlation with Barthel ADL scores at discharge or 16 weeks (r2 = 0.58). Patients with Orpington Score < 3.2 were discharged within 3 weeks of stroke, whereas those scoring > 5.2 required long-term care. Most patients (90%) with Orpington Score of 3-5 were eventually discharged home although this was not always apparent on initial clinical assessment at the time of admission.
  
  
  CONCLUSIONS
  The Orpington score when assessed at 2-weeks post-stroke is a useful prognostic indicator with special suitability for the elderly and may help to select patients most likely to benefit from stroke unit rehabilitation.
authors: Department of Medicine for Elderly People, Bromley Hospitals, United Kingdom.
authors: L
authors: L
authors: Kalra
authors: P
authors: P
authors: Crome
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D003071:Cognition; D005260:Female; D015577:Geriatric Assessment; D015600:Glasgow Coma Scale; D006757:Hospital Units / Q000592:standards; D006801:Humans; D007361:Intelligence Tests; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D009048:Motor Skills; D017063:Outcome Assessment, Health Care; D004856:Postural Balance; D011379:Prognosis; D011434:Proprioception; D011446:Prospective Studies; D012046:Rehabilitation / Q000592:standards; D015203:Reproducibility of Results; D012720:Severity of Illness Index