This study compares the global disability status of mild ischemic stroke patients at 30 and 90 days post-stroke, as measured by the modified Rankin Scale (mRS), and identifies predictors of disability change between 30-90 days.

The final disability status after an ischemic stroke has typically been assessed at 90 days in trials, but it has been shown that the functional status at 30 days post-stroke is a reliable predictor of functional status at 90 days.

Fifty-seven percent of participants had the same mRS at 30 and 90 days. There was moderate agreement in mRS between the two time points (weighted kappa=0.59, 95% CI=0.56-0.62). However, worsening on the mRS was observed in 7.54% of participants from 30-90 days, and 17.33% improved. Participants of older age (per year OR=1.02, 95% CI=1.00-1.03), greater stroke severity (per NIHSS point OR=1.17, 95% CI=1.03-1.34), history of atrial fibrillation (OR=1.72, 95% CI=1.04-2.86), and those without alteplase treatment (OR=1.72, 95% CI=1.10-2.67) were more likely to show functional decline after mutual adjustment.

A quarter of mild ischemic stroke participants exhibited functional changes between 30-90 days, suggesting that the 30-day outcome may insufficiently represent long-term recovery in mild stroke and longer follow-up may be clinically necessary.