Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

IntroductionIf health professionals are to involve major stroke patients and their families in making decisions about treatments, they need to describe prognosis in terms that are easily understood. We suggest that referring to "specific abilities", such as ability to be independent, walk, talk, eat normally, be continent, live without severe pain, live without major anxiety or depression and to live at home may be more easily understood than terms such as disabled based on the modified Rankin scale (mRs).ObjectiveWe aimed to describe the "specific abilities" and quality of life of patients in each mRs level at six months after major stroke.Patients and methodsA longitudinal cohort study of patients admitted to hospital with major stroke with follow up at six months.ResultsWe recruited 403 patients, mean age 77.5yrs. The number (%) in each mRs level at six months was 0 (no problems): 8(2%), 1: 45(11.2%), 2: 7(1.7%), 3: 149(37.1%), 4: 46(11.4%), 5: 36(9.0%) and 6(dead) 111(27.6%). Patients within each mRs level varied with respect to their "specific abilities" and quality of life. For example, of the 36(9%) patients with mRs 5, 30(83%) could talk, 14(39%) were continent, 33(92%) were not in severe pain, 22(61%) did not have major anxiety/depression and 5(14%) could live at home. Their median utility (derived from HRQoL) was -0.08 (range -0.35 to 0.43).Discussion and conclusionsDescribing prognosis with the mRs does not convey the variation in specific abilities and HRQoL amongst patients with major stroke. Therefore, describing prognosis in terms of "specific abilities" may be more appropriate.

Original publication




Journal article


Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

Publication Date





Centre for Clinical Brain Sciences, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom.. Electronic address:


Humans, Disability Evaluation, Prognosis, Activities of Daily Living, Health Status Indicators, Longitudinal Studies, Prospective Studies, Predictive Value of Tests, Communication, Mental Health, Comprehension, Time Factors, Quality of Life, Aged, Aged, 80 and over, Female, Male, Terminology as Topic, Stroke, Symptom Assessment