Predicting final disposition after stroke using the Orpington Prognostic Score.
BACKGROUND
Prediction of outcome after stroke is important for triage decisions, prognostic estimates for family and for appropriate resource utilization. Prognostication must be timely and simply applied. Several scales have shown good prognostic value. In Calgary, the Orpington Prognostic Score (OPS) has been used to predict outcome as an aid to rehabilitation triage. However, the OPS has not been assessed at one week for predictive capability.


METHODS
Among patients admitted to a sub-acute stroke unit, OPS from the first week were examined to determine if any correlation existed between final disposition after rehabilitation and first week score. The predictive validity of the OPS at one week was compared to National Institute of Health Stroke Scale (NIHSS) score at 24 hours using logistic regression and receiver operator characteristics analysis. The primary outcome was final disposition after discharge from the stroke unit if the patient went directly home, or died, or from the inpatient rehabilitation unit.


RESULTS
The first week OPS was highly predictive of final disposition. However, no major advantage in using the first week OPS was observed when compared to 24h NIHSS score. Both scales were equally predictive of final disposition of stroke patients, post rehabilitation.


CONCLUSIONS
The first week OPS can be used to predict final outcome. The NIHSS at 24h provides the same prognostic information.
Wright
C J
CJ
Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, and Rehabilitation Services (Neurosciences Team-FMC), Calgary Health Region, Calgary, AB, Canada.
Swinton
L C
LC
Green
T L
TL
Hill
M D
MD
D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D002170:Canada; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014481:United States