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(Stroke. 2008;39:231.)
© 2008 American Heart Association, Inc.

Research Letters

Time Spent at Home Poststroke

"Home-Time" a Meaningful and Robust Outcome Measure for Stroke Trials

Terence J. Quinn, MRCP; Jesse Dawson, MRCP; Jennifer S. Lees, BA; Tou-Pin Chang; Matthew R. Walters, MD; Kennedy R. Lees, MD for the GAIN and VISTA Investigators

From the Gardiner Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.

Correspondence to Terence J. Quinn, MRCP, Gardiner Institute of Cardiovascular and Medical Sciences, Western Infirmary, Glasgow G116NT, UK. E-mail Tjq1t{at}clinmed.gla.ac.uk

Abstract

Background and Purpose— Stroke outcome assessment requires some measure of functional recovery. Several instruments are in common use but all have recognized limitations. We examined duration of stay in the patient’s own home over the first 90 days since stroke—"home-time"—as an alternative outcome likely to show graded response with improved reliability.

Methods— We examined prospectively collected data from the GAIN International trial using analysis of variance with Bonferroni contrasts of adjacent modified Rankin scale score categories.

Results— We had full outcome data from 1717 of 1788 patients. Increasing home-time was associated with improved modified Rankin scale scores (P<0.0001). The relationship held across all modified Rankin scale grades except 4 to 5.

Conclusions— Home-time offers a robust, useful, and easily validated outcome measure for stroke, particularly across better recovery levels.

Key Words: cerebrovascular accident • health economics • modified Rankin scale score • outcome assessment • stroke treatment