Deans' stroke musings: Index for Multiple Chronic Conditions Predicts Post-Stroke Outcomes

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, October 27, 2020

Index for Multiple Chronic Conditions Predicts Post-Stroke Outcomes

THIS IS WHAT IS SO FUCKING STUPID ABOUT STOKE. Predicting failure to recover. I would fire the whole lot. And until we get survivors in charge nothing will change.

Index for Multiple Chronic Conditions Predicts Post-Stroke Outcomes

A new index for multiple chronic conditions (MCC) was effective for predicting post-stroke functional outcomes and disability/dependency in patients with ischemic stroke, according to study results published in Neurology. The index consisted of pre-stroke modified Rankin scale (mRs), age, weight loss, congestive heart failure (CHF), diabetes, other neurological disorders, and synergistic effects between patient characteristics and comorbidities.

This study aimed to evaluate if a new MCC index would predict functional outcomes following stroke. Study researchers from the University of Michigan used machine learning techniques to develop and internally validate an MCC index that improves prediction of 90-day post-stroke functional outcomes. Researchers developed this index using baseline (after stroke onset) and at 90-day interview data from a prospective cohort of 1035 patients with ischemic stroke (mean age, 68±12.1 years; 51% female) nested in the Brain Attack Surveillance in Corpus Christi (BASIC) Project between November 8, 2008 and March 31, 2017.

The post-stroke functional outcome score was assessed at approximately 90 days after stroke based on a mean score of self-reported levels of difficulty with 7 activities of daily living (ADL) and/or instrumental activities of daily living (IADLs) tasks. Unfavorable functional outcome was defined as a score of at least 3, suggesting the patient had “a lot of difficulty” with ADL/IADLs. Study researchers also abstracted chronic conditions of the patients from medical records and hospital discharge data. There were 22 total chronic conditions considered in the index.

Machine learning techniques were then employed to select and weigh pre-stroke impairments and medical conditions in this cohort. Important predictors in the MCC index included pre-stroke mRs, age, CHF, weight loss, diabetes, and other neurological disorders. Additional synergistic effects between patient characteristics and comorbidities were observed, including dementia with age, CHF with renal failure, and pre-stroke mRS with prior stroke/transient ischemic attack.