Prediction of Discharge Destination After Stroke Using the Motor Assessment Scale on Admission: A Prospective, Multisite Study

Abstract 

Brauer SG, Bew PG, Kuys SS, Lynch MR, Morrison G. Prediction of discharge destination after stroke using the Motor Assessment Scale on admission: a prospective, multisite study.

Objective

To determine if admission functional status, measured with the Motor Assessment Scale (MAS), was predictive of discharge destination to home or residential aged care in patients with stroke undergoing rehabilitation.

Design

Cohort study.

Setting

Inpatient rehabilitation units.

Participants

Adults (N=566) diagnosed with stroke undergoing inpatient physiotherapy at one of 15 units in Australia.

Intervention

Multidisciplinary rehabilitation.

Main Outcome Measure

Discharge home versus residential aged care.

Results

Prestroke residential status, gait ability measured with the MAS (MAS-5), rolling ability (MAS-1), and age were able to correctly predict 99% of patients with stroke discharged home and 33.3% discharged to residential aged care facilities, producing an accuracy of 87.3%. Odds ratios indicate that for every 1-point increase in MAS-5 (gait), subjects were 1.66 times more likely to go home (95% confidence interval [CI], 1.28–2.27; P<.001). Similarly, for every 1-point increase in MAS-1 (rolling), subjects were 1.28 times more likely to go home (95% CI, 1.11–1.49; P<.01).

Conclusions

Two items of the MAS assessed on admission to rehabilitation—gait and rolling—in conjunction with basic demographic information of age and prestroke residential status, were highly predictive of discharge from rehabilitation to home.

Key Words: Cerebrovascular accident, Outcome assessment (health care), Patient discharge, Physical therapy, Rehabilitation