PREDICTING THE DISABILITY OF FIRST-TIME STROKE SUFFERERS AT 1 YEAR - 12-MONTH FOLLOW-UP OF A POPULATION-EASED COHORT IN SOUTHEAST ENGLAND

Background and Purpose The purpose of this study was to predict the fu nctional outcome at 1 year of first-time stroke patients aged younger than 75 years in relation to the severity of stroke and demographic ch aracteristics. Methods Population registers in three districts of sout heast England were established in August 1989, with notification by st roke registry field-workers, general practitioners, and rehabilitation practitioners. Assessments were made using the Barthel index for acti vities of daily living at the time of maximum impairment and at 3 and 12 months after the stroke. Results Of 639 registered stroke patients, 392 without previous disability survived and were assessed for disabi lity at 3 months, of whom 34 (9%) were Severely disabled and 60 (15%) moderately disabled. Initial incontinence was the best single predicto r of disability with a sensitivity of 60% and a specificity of 78%. Tw o hundred twenty-five patients (35%) were eligible for 12-month follow -up; 11% had moderate or severe disability, for which initial incontin ence was the best predictor. Conclusions There is no evidence from thi s study of an association between demographic characteristics and the disability status of stroke survivors in the medium term. Multivariabl e predictors of disability had little advantage over incontinence with in 24 hours of the stroke. The estimates of the prevalence of disabili ty from this large population-based study are relevant when assessing the medium-term needs of stroke patients.