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AM-PAC 6-Clicks Basic Mobility and Daily Activities Scores Predict 90-Day Modified Rankin Score in Patients with Acute Ischemic Stroke Secondary to Large Vessel Occlusion.
AM-PAC 6-Clicks Basic Mobility and Daily Activities Scores Predict 90-Day Modified Rankin Score in Patients with Acute Ischemic Stroke Secondary to Large Vessel Occlusion. Journal of clinical medicine Cho, A., Lakhani, D. A., Balar, A. B., Salim, H., Koneru, M., Hillis, A., Gonzalez Fernández, M., Vagal, V., Urrutia, V., Faizy, T. D., Heit, J. J., Albers, G. W., Mazumdar, I., Chen, K., Sepehri, S., Kim, M., Luna, L., Mei, J., Yedavalli, V. S., Hyson, N. 2024; 13 (23)Abstract
Background: The relative level of functional impairment in stroke patients is a significant determinant of post-acute care. The Activity Measure for Post Acute Care 6-Clicks (AM-PAC) scores for basic mobility and daily activity are rapid standardized assessments whose utilities in predicting long-term stroke outcomes have not yet been studied. Methods: We performed a retrospective analysis of acute ischemic stroke patients and their outcomes. We evaluated the distribution of outcomes using the chi-square test. We then compared the proportions of patients with good stroke outcomes for different combinations of favorable scores. We performed two-proportion z-tests to determine the significance, and p < 0.05 was considered significant. Results: 282 patients met all of the inclusion criteria between 12 January 2017 and 19 March 2023 (M age = 66.4, 59.9% female). After dichotomizing the scores as "favorable" vs. "unfavorable", we found that 128/155 (82.6%) patients with favorable basic mobility had good stroke outcomes vs. 20/127 (15.7%) with unfavorable basic mobility (p < 0.0001). Similarly, for favorable daily activity, it was 103/113 (91.2%) vs. 45/169 (26.6%), for both favorable, it was 100/109 (91.7%) vs. 48/173 (27.7%), and for neither favorable, it was 17/123 (13.8%) vs. 131/159 (82.4%), all with p < 0.0001. When comparing among groups, both favorable patients differed significantly from those with favorable basic mobility alone (p = 0.033) but not those with favorable daily activity alone (p = 0.875). Even after adjusting for age, the odds ratios of favorable scores were greater than 20 for any combination (p < 0.001). Conclusions: Basic mobility and daily activity AM-PAC scores at discharge are independent predictors of anterior circulation acute ischemic stroke outcomes at 90 days.
View details for DOI 10.3390/jcm13237119
View details for PubMedID 39685578