Authors (including presenting author) :
Yeung LH(1), Law WY(1), WONG YC(1)
Affiliation :
(1)Occupational Therapy Department, Princess Margaret Hospital
Introduction :
Modified Barthel Index (MBI) is a measurement scale for self care performance. It is commonly used by Occupational Therapists to record patients' self care ability. It has been proven valid and reliable to use in stroke patients. However, the use of MBI in predicting discharge destination remains uninvestigated and its current cut-off score is arbitrarily chosen.
Objectives :
This study aims to investigate the use of MBI in predicting discharge destination and set up a cut-off score for home discharge after acute stroke.
Methodology :
256 subjects were recruited retrospectively from Acute Stroke Unit of Princess Margaret Hospital. MBI score and discharge destination were collected from electronic medical record system. Subjects were stratified into live with carer group and live alone group for analysis. Receiver Operating Characteristic (ROC) curves were constructed to investigate the optimal cut-off scores of MBI to predict home discharge in two groups of subjects.
Result & Outcome :
ROC curve analyses showed that MBI had high predictive power in home discharge in both groups. In live with carer group, the Area Under Curve (AUC) was 0.955 and the cut-off score of 70/71 yielded the highest weighted Youden’s Index of 1.577. In live alone group, the AUC was 0.979 and the cut-off score of 77/78 yielded the highest weighted Youden’s Index of 1.612. Conclusion: This study shows that MBI is a good instrument to predict home discharge after acute stroke, demonstrating excellent sensitivity, specificity and accuracy. Acute stroke patients who live with carer should be considered discharging home with MBI score > 70; while those live alone should be considered discharging home with MBI score > 77.
