Deans' stroke musings: Reliability of stroke-related disability assessment at discharge from a stroke unit

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.

Thursday, February 19, 2026

Reliability of stroke-related disability assessment at discharge from a stroke unit

'Assessments' DO NOTHING TOWARDS YOUR RECOVERY SO WHY THE FUCK WAS THIS DONE?

Reliability of stroke-related disability assessment at discharge from a stroke unit

Natalia Pożarowszczyk, Iwona Sarzyńska-Długosz, Hanna Ziąbska, Maciej Nowak, Iwona Kurkowska-Jastrzębska, Michał Karliński

DOI: 10.5603/pjnns.106983

Pubmed: 41705961

Abstract

Introduction. The modified Rankin Scale (mRS) score at discharge from the stroke unit (SU) is often used as a surrogate for the 3-month outcome, but the reliability of such an approach remains uncertain. Our aim was to investigate how mRS assessment at SU discharge compares with early post-discharge and 3-month post-discharge evaluation, considering discharge destination.

Material and methods. We prospectively enrolled adult acute stroke patients discharged from a single tertiary SU with residual neurological deficit and mRS 1–4. Functional assessment was made by a single mRS-certified neurologist using the Rankin Focused Assessment (RFA) at SU discharge, and at 7–21 and 83–97 days post-discharge.

Results. Of 116 enrolled patients, 109 completed the early post-discharge assessment and 104 the 3-month follow-up. The agreement between mRS at SU discharge and in the early follow-up was moderate overall (Krippendorff’s alpha 0.71) and in patients discharged from the hospital (alpha 0.68) but poor in those transferred to the rehabilitation ward (RW) (alpha 0.41). Somewhat worse reliability was observed for the 3-month mRS (alpha 0.63, 0.53, and 0.26, respectively). Discharge assessments tended to overestimate dependency, particularly in RW-transferred patients (28.3% vs. 8.6% in discharges from the hospital).

Conclusions. The modified Rankin Scale assessment reliability performed by an experienced neurologist at SU discharge is moderate and significantly poorer in RW-transferred patients. However, on the population level, it seems satisfactory for patients discharged from the hospital, even as a surrogate for the 3-month post-discharge mRS.

Keywords: strokeoutcome assessmentmodified Rankin Scalerehabilitationfunctional recovery