title: Effect of functional status on survival in patients with stroke: is independent ambulation a key determinant?
abstract: OBJECTIVE
  To investigate the effect of functional status, measured using the Modified Rankin Scale (MRS), at 3 months after stroke on survival in patients with stroke.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Referral medical center.
  
  
  METHODS
  Patients with stroke (N=1032).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Survival after stroke.
  
  
  RESULTS
  The Kaplan-Meier survival curves stratified by the 3-month MRS score showed 2 clear groups of patients with 3-month MRS scores of 0 to 3 (able to walk without assistance) and 4 or 5 (unable to walk without assistance). Accordingly, we grouped the patients into a high function (HF) group (3-month MRS≦3) and a low function (LF) group (3-month MRS≧4). Multiple Cox regression analysis showed that the LF group had significantly poorer survival (adjusted hazard ratio=4.69; 95% confidence interval [CI], 2.89-7.60; P<.001) than the HF group. Other significant risk factors of higher mortality were older age, history of diabetes mellitus, and heart disease.
  
  
  CONCLUSIONS
  This study showed a significant influence of the 3-month MRS score on stroke survival. Moreover, independent ambulation may be a major determinant of a favorable survival prognosis. This finding suggests a potential role of rehabilitation in promoting stroke survival by maximizing ambulation function.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hsi-Ting
authors.initials: HT
authors.lastname: Chiu
authors.forename: Yen-Ho
authors.initials: YH
authors.lastname: Wang
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
authors.forename: Bang-Bin
authors.initials: BB
authors.lastname: Chen
authors.forename: Shin-Liang
authors.initials: SL
authors.lastname: Pan
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000401:mortality* / Q000523:psychology; D000071939:Stroke Rehabilitation; D013534:Survival