Assessment of degree of disability by using Barthel Index and modified Rankin Scale and determinants of disability among acute stroke patients admitted to Teaching Hospital Karapitiya – A descriptive study

Background: Acute stroke results in functional disability, measurable using the well-known Barthel Index (BI) and modified Rankin Scale (mRS). The objectives of the study were to describe the degree of disability following stroke using BI and mRS and to describe its changes from presentation up to 3 months post-stroke, among patients with acute first ever stroke admitted to Teaching Hospital Karapitiya.
Methods: A total of 170 in-hospital acute stroke patients were recruited during 07/2019 -11/2019 and their BI and mRS scores were measured at the time of presentation, at 1- and 3-months post-stroke. The first assessment was a face-to-face encounter, while assessments at 1 and 3 months were carried out through telephone interviews. The determinants of disability included stroke subtypes, age, sex, and time of measurement of disability.
Results: There were 170 patients in the study. The mean age was 67.34 years (standard deviation (SD) 13.43). Males 92 (54.11%) and females 78 (45.88%). 105 (61.76%) were detected to have an ischaemic stroke while 65 (38.23%) presented with a haemorrhagic stroke. The total mean BI scores at presentation, at 1 and 3 months were 22.78 (SD 30.57), 63 (SD 23.01) and 83.15 (SD 23.10) respectively. In the patients with ischaemic stroke the BI scores at presentation, at 1 and 3 months were 25.52 (SD 30.53), 61.42 (SD 28.1) and 81.72 (SD 24.04) respectively. In patients with a haemorrhagic stroke, the BI at presentation, at 1 month and at 3 months were 16.92 (SD 28.58), 65.15 (SD 30.67) and 89.64 (SD19.33) respectively. mRS scores showed similar findings.
Conclusion: Overall, the mean BI scores and mRS showed an increased trend of improvement in disability from the time of presentation up to 3 months post-discharge among acute stroke patients.
The age at presentation showed a significant correlation with disability at presentation. Sex and stroke subtype did not demonstrate a significant association with disability at presentation.