Decisions about thrombectomy and rehabilitation in older patients turn on how well they managed before the stroke. Ask family or carers at the first contact whether the patient lived independently, walked unaided and managed personal care, and record a pre-stroke Rankin score. It is far harder to reconstruct a day later.
- Ask family about independence, walking and personal care before the stroke.
- Record a pre-stroke modified Rankin score in the admission note.
- Use pre-stroke function, not age, to frame treatment discussions.
Why it matters
Age is an easy proxy for frailty, but pre-stroke function is the one that predicts benefit.
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