Abstract T P278: The Addition of the Post-Stroke Checklist to Standard Outcome Measures During a 90 Day Post-Stroke Follow-up Evaluation Identifies Unique Unmet Needs Relevant to Stroke Recovery

Background: The Post Stroke Checklist (PSC) is an easily administered tool to identify unmet needs in stroke patients. The relative value of the PSC compared to other outcome measures has yet to be determined. We have evaluated the utility of the PSC at 30 days post-stroke, and now report the use of the PSC at 90 days post-stroke. Methods: We evaluated 213 ischemic stroke patients 90 days post discharge in our Stroke Clinic. The PSC was administered as well as the Barthel Index (BI) and modified Rankin Scale (mRS) - scored by a nurse and reviewed by a stroke physician. We stratified each scale according to severity and identified actionable PSC items. Using Fisher’s Exact Test we tested for differences in each of the 11 individual items across the two mRS and BI stratified severity groups. Wilcoxon Rank Sum test measured differences in total PSC score (range 0-9) across mRS and BI severity groups. Results: 103 patients responded positively to one or more PSC items. The cognition item had the highest frequency, 51 (23.9%) of positive responses followed by the mood item, 33 (15.49). The median (range) BI was 100 (10-100) and mRS was 1 (0-5). Patients were distributed across the two BI and mRS severity groups: BI-S (more severe) 0-89 (n=26) and BI-L (less severe) 90-100 (n=187); mRS-S (more severe) 3-5 (n=31) and mRS-L (less severe) 0-2 (n=159). There were significant differences in total PSC scores across both mRS (p=<0.0001) and BI (p=.002) severity groups. There were significant differences in the mood (p=<0.0001), cognition (p=0.004), and life after stroke (p=0.014) items across the mRS severity groups. Patients in the more severe mRS group had higher proportion of positive responses on the mood, cognition and life after stroke items. Conclusion: The PSC identified a substantial proportion of unmet needs in both low severity and high severity stroke patients. The highest frequency related to cognitive function and mood/mental health - often overlooked if not probed for. Our results suggest the importance of cognitive and mental health assessment/referral, especially for high severity stroke patients.