PLAN Clinical Prediction Rule of O'Donnell et al for a Patient with Acute Ischemic Stroke

Description

O'Donnell et al reported the PLAN clinical prediction rule for determining outcomes for a patient with an acute ischemic stroke. The authors are from the National University of Ireland, University of Toronto, Joseph Brant Hospital (Burlington) and Hamilton Health Sciences.

PLAN = preadmission comorbidities (P), level of consciousness (L), age (A) and neurologic deficit (N)

Patient selection: acute ischemic stroke

Outcome: death or severe disability (modified Rankin scale 5 or 6)

Parameters:

(1) preadmission dependence

(2) history of cancer

(3) congestive heart failure

(4) atrial fibrillation

(5) level of consciousness

(6) age in years

(7) arm weakness

(8) leg weakness

(9) neglect or aphasia

Parameter	Finding	Points
preadmission dependence	absent	0
	present	1.5
history of cancer	absent	0
	present	1.5
congestive heart failure	absent	0
	present	1
atrial fibrillation	absent	0
	present	1
level of consciousness	normal	0
	reduced	5
age in years		INTEGER(age/10)
arm weakness	normal or mild	0
	signficant or total	2
leg weakness	normal or mild	0
	significant or total	2
neglect or aphasia	absent	0
	present	1

where:

• The maximum score for age was given as 10 (which would cover to 109).

total score =

= SUM(points for all 9 parameters)

Interpretation:

• minimum score: based on age

• maximum score: 25

• The higher the score the worse the outcome.

Score	30-Day Mortality	In Hospital Death or Severe Dependence at Discharge
<= 5	1%	1%
6 to 9	2.5%	2.5%
10 to 12	7.5%	10%
13 to 15	20-23%	27.5%
16 to 19	48%	55-61%
20 to 25	58 to 70%	76 to 80%

To read more or access our algorithms and calculators, please log in or register.

PLAN Clinical Prediction Rule of O'Donnell et al for a Patient with Acute Ischemic Stroke

Description

Specialty