Objective To assess the appropriateness of Barthel Index (BI) and Modified Rankin Scales (MRS) used as long-term outcome measures in a stroke data register and to investigate the correlation between cutoff points of the two scales in different stroke patients with and without disability. Methods Nine hundred and twelve patients were registered prospectively. BI and MRS were evaluated at the end of 1, 3, 6 and 12 months after stroke onset. The distribution, ceiling effects and floor effects of the two scales were evaluated. A logistic regression model was established to investigate correlation of cutoff points of BI and MRS. Results There were a total of 2 829 evaluation points of BI and MRS. The percentages of patients reaching the maximum scores of BI at the end of 3, 6 and 12 months (54.8％, 62.2％ and 68.3％, respectively) were higher than those of MRS. There was significant correlation between the two scales (Spearman’s correlation coefficient 0.887, P＜0.05), when MRS scores of ≤1 and ≤2 were taken as cutoff points, the corresponding cutoff points of BI score were ≥90 and ≥85, respectively. Conclusions BI has significant ceiling effects when used as long-term outcome measurement in a stroke data register. There was significant correlation between BI and MRS scores. In future clinical studies, an MRS score ≤2 or BI score ≥85 could be used as cutoff points in predicting stroke patients with and without disability.
ObjectiveTo investigate the correlation between the Barthel index score and other factors before revision total hip arthroplasty (THA) and the incidence of lower extremity deep venous thrombosis (DVT). MethodsThe clinical data of 122 THA revision patients who met the selection criteria between April 2017 and November 2020 were retrospectively analyzed. There were 61 males and 61 females with an average age of 65.3 years ranging from 32 to 85 years. The causes of revision were periprosthetic infection (7 cases), periprosthetic fracture (4 cases), prosthesis dislocation (6 cases), and aseptic loosening (105 cases). The Barthel index score was 76.4±17.7, including 10 cases of grade 1, 57 cases of grade 2, 37 cases of grade 3, and 18 cases of grade 4. Univariate analysis was performed on the age, gender, body mass index, Barthel index score, positive D-dimer, history of diabetes, hypertension, history of tumor, history of cerebral infarction, history of smoking, and history of thrombosis in patients with and without DVT before operation. The risk factors of DVT before revision THA were further screened by logistic regression analysis, and the incidence of DVT before revision THA was compared among different Barthel index grade. ResultsEleven patients (9.02%) were found to have preoperative DVT, all of which were intermuscular venous thrombosis. The causes of revision were periprosthetic infection in 1 case, periprosthetic fracture in 1 case, prosthesis dislocation in 1 case, and aseptic loosening of prosthesis in 8 cases. Univariate analysis showed that there were significant differences in age, gender, and Barthel index score between the two groups (P<0.05). Further logistic regression analysis showed that female, age ≥70 years, and Barthel index score <60 were independent risk factors for DVT before THA revision (P<0.05). Preoperative DVT occurred in 0 (0), 2 (3.5%), 3 (8.1%), and 6 (33.3%) patients with Barthel index grade 1, 2, 3, and 4, respectively. There was a correlation between Barthel index grade and the incidence of DVT before THA revision (P=0.001). ConclusionIn patients undergoing revision THA, older age, female, and lower Barthel index score were associated with a higher incidence of preoperative DVT. For patients with low preoperative Barthel scores, preoperative screening for thrombosis should be emphasized.