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  • De Havenon, AdamUniversity of Utah (författare)

Variability of the Modified Rankin Scale Score between Day 90 and 1 Year after Ischemic Stroke

  • Artikel/kapitelEngelska2021

Förlag, utgivningsår, omfång ...

  • 2021

Nummerbeteckningar

  • LIBRIS-ID:oai:lup.lub.lu.se:80fe4f25-00a5-4679-9f6a-bab6f01fcae7
  • https://lup.lub.lu.se/record/80fe4f25-00a5-4679-9f6a-bab6f01fcae7URI
  • https://doi.org/10.1212/CPJ.0000000000000954DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:art swepub-publicationtype
  • Ämneskategori:ref swepub-contenttype

Anmärkningar

  • Objective Studies indicate that the functional outcome evolves in the year after ischemic stroke onset. However, the traditional outcome measure in stroke trials is the modified Rankin Scale (mRS) at 90 days from onset. To determine mRS fluctuations in the first year after stroke, we examined data from 3 major stroke trials.MethodsIn a secondary analysis, we evaluated intrapatient mRS between 90 days and 1 year from stroke onset, the mRS shift (ΔmRS = 1 year-day 90), and the trials' primary outcome at day 90 and 1 yearResultsWe included 624 patients from the National Institute of Neurological Disorders and Stroke rt-PA Stroke Study, 587 from Albumin Treatment for Acute Ischaemic Stroke, and 611 from Interventional Management of Stroke III, for which the proportion of patients with a ΔmRS change between day 90 and 1 year was 36.5%, 41.7%, and 36.0%. However, the trials' primary outcomes did not differ at 1 year vs 90 days. Similar findings were seen in a second cohort where we pooled the trials and excluded patients with recurrent stroke or death during the follow-up. In those 1,314 patients, 544 (41.4%) had a ΔmRS change, of which 379 (28.9%) had improvement and 165 (12.5%) had worsening, apart from death.ConclusionWe describe the patient-level spectrum of mRS change from day 90 to 1 year after ischemic stroke in 3 high-quality randomized trials. The patient-level shifts consisted of a sufficiently counterbalanced number of mRS improvements and declines, which masked clinical evolution occurring in over one-third of patients. These results may have important implications, both for clinical trial design and outcome adjudication in stroke research and duration of rehabilitative therapy.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Tirschwell, David L.University of Washington (författare)
  • Heitsch, LauraUniversity of Washington (författare)
  • Cramer, Steven C.University of California, Los Angeles (författare)
  • Braun, RobynneUniversity of Maryland (författare)
  • Cole, JohnUniversity of Maryland (författare)
  • Reddy, VivekUniversity of Utah (författare)
  • Majersik, Jennifer J.University of Utah (författare)
  • Lindgren, ArneLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Stroke Research Group,Lund University Research Groups(Swepub:lu)neur-ali (författare)
  • Worrall, Bradford B.University of Virginia (författare)
  • University of UtahUniversity of Washington (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Neurology: Clinical Practice11:3, s. 239-2442163-0402

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