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Abstract
OBJECTIVE: To assess the influence of two functional scales- Modified Rankin Scale (m-RS) and Modified Katz Index (m-Katz Index) on long-term mortality in a stroke cohort.
MATERIAL AND METHODS: Among 760 stroke survivors (median age: 66 (IQR:56-75), 56.4 % women) m-Katz Index and m-RS scales applied at 1 and 6 months after stroke, were investigated in relation to 12-years of all-cause mortality. Kaplan-Meier survival curves were computed, and time-varying covariate Cox regression models were fitted to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs) in all sample and by sex. The prognostic ability of the fitted models was computed for each model by six different measures.
RESULTS: After 12 years of follow-up (median survival time: 7.3 years), 311 participants died. Overall survival curves show lower survival rates among those with the highest levels of disability/dependence (all log-rank p-values <0.0001). These findings were confirmed in all regression models for both sexes, particularly in men who had higher levels of dependence on Activities of Daily Living (ADLs) by m-Katz Index and severe disability by m-RS and presented the highest HR of dying (HR: 3.34 (95 %CI: 2.27-4.92) and HR: 4.94 (95 % CI: 3.15-7.75), respectively).
CONCLUSIONS: Both the m-Katz Index and the m-RS scale were good predictors of long-term mortality, which is of importance for guiding the functional rehabilitation of stroke patients. Besides, high levels of disability and dependence were implicated with high mortality risks, regardless of sex.
Original language | English |
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Article number | 107487 |
Number of pages | 7 |
Journal | Journal of Stroke and Cerebrovascular Diseases |
Volume | 33 |
Issue number | 1 |
Early online date | 17 Nov 2023 |
DOIs | |
Publication status | Published - Jan 2024 |
Bibliographical note
Grant support:This study was funded by the Sao Paulo Research Support Foundation of the State of São Paulo (FAPESP) (grant no 18/05512-3) and by the NIHR Global Health Research Group of AF (grant no 17/63/121).
Copyright:
© 2023. Published by Elsevier Inc.
Keywords
- Cerebrovascular
- Rehabilitation medicine/Physical therapy
- Poststroke survival
- Epidemiology
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NIHR Global Research Group on Atrial Fibrillation - OPEN FOR DISSEMINATION ONLY
Lasserson, D. (Co-Investigator), Manaseki-Holland, S. (Co-Investigator), Cheng, K. (Co-Investigator), Moore, D. (Co-Investigator), Jolly, K. (Co-Investigator), Greenfield, S. (Co-Investigator), Jowett, S. (Co-Investigator), Brocklehurst, P. (Co-Investigator), Nirantharakumar, K. (Co-Investigator), Szmigin, I. (Co-Investigator), Kirchhof, P. (Co-Investigator), Gough, R. (Co-Investigator) & Thomas, N. (Principal Investigator)
NIHR CENTRAL COMMISSIONING FACILITY
1/04/18 → 30/11/24
Project: Other Government Departments