Systematic review to identify proxy measures to assess post-stroke functional outcomes

Autor: Olivia S. Costa, Mark J. Alberts, Mary J. Christoph, Belinda Lovelace, Jonathon Rocco, Craig I. Coleman
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Health Sciences Review, Vol 5, Iss , Pp 100057- (2022)
Druh dokumentu: article
ISSN: 2772-6320
58211721
DOI: 10.1016/j.hsr.2022.100057
Popis: Objectives: To perform a systematic review of studies evaluating prognostic factors (proxy measures) to predict patients’ post-stroke functional outcome status recommended by clinical guidelines. Materials and methods: MEDLINE and Embase databases were searched from January 1, 2000, through January 8, 2021. Studies that evaluated stroke survivors and assessed a proxy measure's ability to predict functional outcome status as measured by the modified Rankin Scale (mRS), Barthel Index (BI), Glasgow Outcomes Scale, and/or Functional Independence Measure between 30 and 365 days post-stroke were included. Results: Nine studies met inclusion criteria (median N per study = 1699; range: 530–6809). Seven studies evaluated ischemic stroke ± transient ischemic attack (TIA), 1 evaluated subarachnoid hemorrhage, and 1 evaluated both ischemic and hemorrhagic stroke and TIA (each reported separately). All studies utilized mRS score to assess post-stroke functional outcome, while 3 utilized the BI. Home-time was the most frequently evaluated proxy (7/9, 77.8%) and had moderate-to-strong correlation/discriminative ability with 3- to 12-month post-stroke functional outcome measurement. Home-time was less able to discriminate between neighboring mRS score values >3 and was only weakly-to-moderately correlated with mRS in TIA patients. Discharge to a location other than home or a relative's home was assessed in 2 of 9 studies (22.2%) and was found to be a moderate-to-strong correlate/predictor of unfavorable mRS score. In a single study, index hospital length of stay weakly correlated with post-stroke function status. Conclusions: This systematic review provides evidence supporting the use of home-time and discharge destination as proxy measures for predicting post-stroke functional outcome.
Databáze: Directory of Open Access Journals
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