The Orpington Prognostic Score as a predictor of functional outcome following stroke as determined by the Modified Barthel Index

Abstract

BACKGROUND: The Orpington Prognostic Score (OPS) is a prognostic indicator, used to assess and target rehabilitation and therapy resources for people who have had a stroke. PURPOSE: The aim of this study was to investigate the ability of the OPS, and selected clinical variables, to predict functional outcome post-stroke, as determined by the Modified Barthel Index (MBI), in a stroke rehabilitation unit. METHODS: This was a prospective observational cohort study in a stroke rehabilitation unit. All participants were assessed with the OPS on admission to the unit. All participants were assessed with the MBI on admission and again on discharge from the unit. Participants’ level of mobility prior to discharge was measured using the ambulation subsection of the MBI. Participants’ discharge destination was also recorded. RESULTS: A total of 32 people who had complete data on the variables of interest were included in the final analysis. Based on the OPS, 19 participants (59.4%) were classified as having had a mild stroke, 11 (34.4%) were classified as having had a moderate stroke, with only two participants (6.2%) classified as having had a severe stroke. OPS scores were found to be statistically significant in independently predicting discharge MBI (p< 0.05). Those participants who achieved a higher level of mobility prior to discharge from the stroke rehabilitation unit had a lower OPS score on admission to the unit, indicating a milder stroke. OPS scores were not predictive of discharge location. CONCLUSION: Results of this study indicate that assessing people, who have had a stroke, with the OPS on admission for rehabilitation may assist in predicting functional outcome. The OPS should not be used in isolation to determine who is accepted for rehabilitation, but should be included as a component in patient assessment.