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New prognostic model predicts recovery after stroke

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – A new prognostic model predicts recovery from stroke at various stages of rehabilitation and may improve clinical decision-making, according to a report in the December issue of Stroke.

Dr. Kate Tilling, of King's College London, UK, and colleagues demonstrate the clinical utility of their newly developed prognostic model that takes into account early changes in recovery and individual patient characteristics. They prospectively collected data on functional recovery (Barthel Index) for 299 stroke patients at 0, 2,4, 6, and 12 months after stroke.

"Multilevel models were used to model recovery trajectories, allowing for day-to-day and between-patient variation," the researchers explain. "The predictive performance of the model was validated with an independent cohort of 710 stroke patients," they note.

Urinary incontinence, sex, prestroke disability, and dysarthria were associated with a lower level of recovery after stroke, the team reports. However, they note that the effects of these factors did not vary over time. Age, dysphasia, and limb deficit also affected the rate of recovery, and their effects did vary over time.

"Applying this to the validation cohort, the average difference between predicted and observed Barthel Index was -0.4, with 90% limits of agreement from -7 to 6," the investigators write. "Predicted Barthel Index lay within three points of the observed Barthel Index on 49% of occasions and improved to 69% when patients' recovery histories were taken into account."

"This model is a potentially useful tool for comparing individual patients with average recovery trajectories," Dr. Tilling and colleagues conclude. They note that at-risk patients could be identified with the model and interventions could be initiated.

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