Discharge Destination as a Surrogate for Modified Rankin Scale Defined Outcomes at 3 and 12 Months among Stroke Survivors (P07.014)

Abstract

Objective: Analysis of the prospectively collected data from a randomized, placebo-controlled trial in patients with ischemic stroke presenting within 3 hours of symptom onset. Post hoc analysis of patients recruited in a clinical trial. Background To determine the validity of discharge destination as a surrogate for defining favorable and unfavorable outcomes at 3 and 12 months and magnitude of under- or over-estimation of favorable and unfavorable outcomes. Design/Methods: A total of 530 patients were discharged alive from the hospital after ischemic stroke. Positive and negative predictive value and likelihood ratios of discharge destination for unfavorable outcome at 3 and 12 months defined by a modified Rankin scale (mRS) of 2-6, mRS 3-6, or mRS 4-6. We also evaluated the predictive value and likelihood ratios of discharge destination for unfavorable outcome at 3 and 12 months in two strata defined by age (≤65 years and >65 years). Results: The positive predictive value of discharge to nursing home/rehabilitation facility was the highest for unfavorable outcome defined by mRS 2-6 (90%), as compared with those defined by mRS of 3-6 (79%) and of 4-6 (57%). The positive likelihood ratio was high for unfavorable outcome defined by mRS 2-6 at 3 months (6.18, 95% CI 4.29-8.90). The likelihood ratio for unfavorable outcome (mRS 2-6) was higher among those aged ≤65 years (6.8, 95% CI 3.61-13) compared with those aged >65 years (5.73, 95% CI 3.67-8.95). Conclusions: Our results provide insight into the use of discharge destination as a surrogate measure for death and disability at 3 months as defined by mRS. Disclosure: Dr. Anderson has nothing to disclose. Dr. Chaudhry has nothing to disclose. Dr. Rodriguez has nothing to disclose. Dr. Suri has nothing to disclose. Dr. Qureshi has nothing to disclose.