TJC2026A Note for "Modified Rankin Score (mRS at 90 Days)"

• Topic Version for Release TJC2026A: 47
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Rationale

The rationale for the measure and references were updated to address 2025 stroke statistics from the American Heart Association.

Description

Rationale
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The Modified Rankin Scale (mRS) is the accepted standard for assessing recovery post-stroke. As such, it has become the most widely used clinical outcome measure for stroke clinical trials. Scores are used to measure the degree of disability or dependence in activities of daily living. Score reliability and reproducibility are improved through use of a structured interview by a trained evaluator. Interviews may be conducted in-person or over the phone. According to guideline recommendations from the American Heart Association/American Stroke Association, standardized interviews to obtain a mRS score should be conducted for acute ischemic stroke patients treated with IV or IA alteplase therapy or mechanical endovascular reperfusion therapy at 3 months (90 days); however, recovery may continue well beyond 3 months for many ischemic stroke patients.

To:
The Modified Rankin Scale (mRS) is the accepted standard for assessing recovery post-stroke. As such, it has become the most widely used clinical outcome measure for stroke clinical trials. Scores are used to measure the degree of disability or dependence in activities of daily living. Score reliability and reproducibility are improved through use of a structured interview by a trained evaluator. Interviews may be conducted in-person or over the phone. According to guideline recommendations from the American Heart Association/American Stroke Association, standardized interviews to obtain a mRS score should be conducted for acute ischemic stroke patients treated with IV or IA alteplase therapy or mechanical endovascular reperfusion therapy at 3 months (90 days); however, recovery may continue well beyond 3 months for many ischemic stroke patients.

Recent clinical studies (e.g., AURORA, BEST, BASICS, BAOCHE, ATTENTION) have evaluated stroke disability at 90 days following endovascular therapy (EVT) for patients with large vessel occlusions. Patients undergoing EVT were more likely to achieve favorable outcomes and functional independence as assessed by mRS score of 0-2 when compared to medical management.

Selected References
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• Martin, S.S., Aday, A.W., Allen, N.B., Almarzooq, Z.I., Anderson, C.A.M., Arora, P.,…Palaniappan, L.P. “2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.” [In eng]. Circulation 151, (Feb 25 2025): e354.

Special Notice
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*SUSPENDED for Thrombectomy-Capable Stroke Centers, Effective July 1, 2022*