Introduction: Clinical trials forming the basis of current guidelines for the management of intracranial aneurysms have relied on patient-reported Modified Rankin Scale values (mRS) to assess patient functional outcome. The effect of patient demographics on perception of disability, and by extension patient-reported mRS, is not well understood.
Methods: Patients with an unruptured intracranial aneurysm (UIA) were prospectively instructed to assign themselves a mRS with the aid of an explanatory form. Concurrently, a nurse (D.J.) performed an independent assessment of patient mRS based on a structured interview to assess patients’ functional status. Information on patient characteristics, including age, sex, and education level, as well as major health problems unrelated to their UIA was prospectively collected. The relationship of patient characteristics to self- and nurse-reported mRS was assessed using the Student’s t-test and linear regression analysis.
Results: There were 233 patients with an UIA enrolled in the study. The majority of patients were female (179/233, 76.8%). The mean age of our cohort was 60.7 years (SD: 13.3). Mean patient- and nurse-reported mRS were 1.3 (SD: 0.9) and 1.2 (SD: 0.7; p = 0.094), respectively. Age was positively correlated to nurse-reported (r2 = 0.075, p <0.001) but not patient-reported mRS (r2 = 0.011, p = 0.116). There was a trend towards higher patient-reported mRS in female patients (1.4 vs 1.1; p = 0.097). There were significant differences between patient- and nurse-reported mRS in female (1.4 vs 1.3; p = 0.039) but not male patients (1.1 vs 1.1; p = 0.810). Female patients without a college degree had greater patient- (1.4 vs 1.2; p = 0.017) and nurse-reported mRS (1.3 vs 1.1; p = 0.042).
Conclusions: Our results suggest that patient demographics may influence perception of disability. These findings should be considered when employing patient-reported mRS to determine functional outcome.
Patient Care: Our research may influence how functional outcome in patients with intracranial aneurysms is assessed, thereby potentially increasing the validity of future research findings.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Identify patient characteristics that may influence patient reported modified Rankin Scale values, 2)Describe how different patient characteristics influence patient reported modified Rankin scale values.