Abstract T P113: Orpington Prognostic Scale: A Predictive Tool for Discharge Outcome in a Hyper Acute Stroke Unit

Abstract

Introduction: An accurate assessment of the severity of impairment and prediction of prognosis following stroke is important for determining rehabilitation needs of stroke patients. The study investigated the predictive ability of the Orpington Prognostic Scale (OPS) administered within 72 hours of stroke onset, in determining discharge destination post admission to a Hyper Acute Stroke Unit (HASU) in the United Kingdom. Method: Prospective analysis of OPS data were collected from 247 patients with confirmed diagnosis of stroke admitted to HASU. OPS scores were recorded between 0 to 72hours of admission and compared to discharge destination at 72 hours. Predictive ability of the tool and association with other variables were analysed using logistic regression and multivariate analysis. Results: Low OPS score (<3.2) had high positive predictive value (PPV 88.63%)for discharge home and high OPS score (>3.2) had high predictive value (PPV 98.39) for patients requiring further inpatient rehabilitation. OPS had high specificity and sensitivity for the above, independent of age, gender, type and site of stroke, stroke severity, previous social support and co-morbidity. Conclusions: OPS could be a valuable tool in predicting the discharge destination from a HASU and thereby facilitate the identification of early rehabilitation needs, 72 hours post stroke by predicting the need for further management. OPS < 3.2 were highly likely to go home with or without support/therapy. Whereas OPS > 3.2 were highly likely to require further medical/therapy input in an inpatient setting.