Modified rankin scale is a reliable tool for the rapid assessment of stroke severity and predicting disability outcomes

Apoorv A Nimbvikar; Suhrud Panchawagh; Abhijit P Chavan; Jitendra R Ingole; Yash Pargaonkar; Rohan Pai

doi:10.4103/jfmpc.jfmpc_1431_23

Modified rankin scale is a reliable tool for the rapid assessment of stroke severity and predicting disability outcomes

J Family Med Prim Care. 2024 Mar;13(3):1085-1090. doi: 10.4103/jfmpc.jfmpc_1431_23. Epub 2024 Apr 4.

Authors

Apoorv A Nimbvikar¹, Suhrud Panchawagh^{1

2}, Abhijit P Chavan¹, Jitendra R Ingole¹, Yash Pargaonkar¹, Rohan Pai^{1

3}

Affiliations

¹ Department of Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.
² ReQuir Statistical Solutions, All India Institute of Medical Sciences, New Delhi, India.
³ Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Background: 'Time is brain' goes the adage. Rapid and precise management of stroke is of the utmost essence. The modified National Institutes of Health Stroke Scale (mNIHSS) and the modified Rankin Scale (mRS) predict stroke severity and functional disability outcomes. However, the mRS can be administered more rapidly than the mNIHSS and therefore might be better to assess patient outcomes. Hence, the aim of this study was to assess the correlation of stroke severity on admission and functional disability outcomes on the day of discharge or on the 8^th day of hospitalization.

Materials and methods: This was an observational, cross-sectional study with a sample size of 61 participants. The mNIHSS score was calculated on admission for patients with clinical features suggestive of stroke and mRS was calculated on the 8^th day of hospitalization or on discharge. Evaluation of the association between continuous variables was done using Spearman's correlation analysis.

Results: Correlation between mNIHSS and mRS was positive and statistically significant (rho = 0.866, 95% CI [0.751, 0.925]. For each point increase in the mNIHSS, the odds of having higher mRS scores are 153% more than the odds of having lower mRS scores (aOR = 2.534, 95% CI [1.904, 3.560]).

Conclusion: Our study concluded that mRS can be reliably used to predict the functional outcomes for patients with stroke in circumstances where the mNIHSS may prove to be lengthy. Thus, where 'time is brain', the mRS can be used with a similar power to predict the outcome.

Keywords: Functional outcomes; modified NIHSS; modified Rankin Scale; stroke; stroke prognosis; stroke severity.