Prediction of discharge destination after stroke using the motor assessment scale on admission: a prospective, multisite study.

ABSTRACT

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.