Abstract WP148: Functional Independence Score of Acute Stroke Patients Can Predict Favorable Clinical Outcome at 3 Months After Stroke Onset

Abstract

Background and Purpose: Modified Rankin scale (mRS) score at 3-month after onset is widely used as clinical outcomes in stroke patients. Functional Independence Measure (FIM) is a valid tool to estimate the level of ADL. However, there were few studies whether FIM score in acute stroke patients can predict clinical outcomes at 3-month. Our aim is to reveal that FIM scores of acute stroke patients can predict favorable outcome (mRS 0-1 at 3-month). Method: We used data from a prospectively collected observational registry in single stroke center between January 2016 and March 2017. Baseline NIHSS score, acute FIM score (=within 3 days from admission to the stroke unit), discharge FIM score (=at discharge from the stroke unit), and mRS score (before stroke, at 3-month) were collected. The relationship between discharge FIM score and mRS score at 3-month were examined using Spearman’s rank correlation test. Logistic regression analyses were used to reveal the predictors of favorable outcome. Results: Of 678 patients were admitted to our stroke center due to acute stroke, 410 patients whose clinical data could be obtained (60%; mean age, 74±13 years; male, 57%; the median of length of hospital stay, 21 days; 75% with ischemic stroke) were enrolled. The median of the baseline NIHSS score, acute and discharge FIM scores were 5 (interquartile range [IQR], 2-16), 53 (IQR 22-83), and 86 (IQR 32-119), respectively. Discharge FIM score strongly correlated with mRS score at 3 month (ρ=-0.86; p<0.01). In univariate logistic regression analysis, male sex, acute ischemic stroke, premorbid mRS score, baseline NIHSS score, acute FIM score, the length of hospital stay, and discharge FIM score were associated with favorable outcome. In multivariate logistic regression analysis, male sex (odds ratio [OR] 2.28; 95% confidence interval [CI] 1.21-4.36; p=0.01), premorbid mRS score (OR 0.45; 95% CI, 0.26-0.74; p=0.01), length of hospital stay (OR 0.96; 95% CI 0.93-0.99; p=0.02), and discharge FIM score (OR 1.07; 95% CI 1.05-1.09; p<0.01) were independent predictors of favorable outcome. Conclusions: FIM score at discharge from the stroke unit can predict favorable clinical outcome at three months. Our results can help stroke physicians to expect stroke patients’ status in the chronic phase.