Three-month modified Rankin Scale as a determinant of 5-year cumulative costs after ischemic stroke: An analysis of 11,136 patients in Korea

Seong Eun Kim, Heeyoung Lee, Jun Yup Kim, Keon Joo Lee, Jihoon Kang, Beom Joon Kim, Moon Ku Han, Kang Ho Choi, Joon Tae Kim, Dong Ick Shin, Min Ju Yeo, Jae Kwan Cha, Dae Hyun Kim, Hyun Wook Nah, Dong Eog Kim, Wi Sun Ryu, Jong Moo Park, Kyusik Kang, Jae Guk Kim, Soo Joo LeeMi Sun Oh, Kyung Ho Yu, Byung Chul Lee, Hong Kyun Park, Keun Sik Hong, Yong Jin Cho, Jay Chol Choi, Sung Il Sohn, Jeong Ho Hong, Moo Seok Park, Tai Hwan Park, Sang Soon Park, Kyung Bok Lee, Jee Hyun Kwon, Wook Joo Kim, Jun Lee, Ji Sung Lee, Juneyoung Lee, Atte Meretoja, Philip B. Gorelick, Hee Joon Bae

    Research output: Contribution to journalArticlepeer-review

    22 Citations (Scopus)


    ObjectiveStroke is a devastating and costly disease; however, there is a paucity of information on long-term costs and on how they differ according to 3-month modified Rankin scale (mRS) score, which is a primary outcome variable in acute stroke intervention trials.MethodsWe analyzed a prospective multicenter stroke registry (Clinical Research Collaboration for Stroke in Korea) database through linkage with claims data from the National Health Insurance Service with follow-up to December 2016. Healthcare expenditures were converted into daily cost individually, and annual and cumulative costs up to 5 years were estimated and compared according to the 3-month mRS score.ResultsBetween January 2011 and November 2013, 11,136 patients were enrolled in the study. The mean age was 68 years, and 58% were men. The median follow-up period was 3.9 years (range 0-5 years). Mean cumulative cost over 5 years was $117,576 (US dollars [USD]); the cost in the first year after stroke was the highest ($38,152 USD), which increased markedly from the cost a year before stroke ($8,718 USD). The mean 5-year cumulative costs differed significantly according to the 3-month mRS score (p < 0.001); the costs for a 3-month mRS score of 0 or 5 were $53,578 and $257,486 USD, respectively. Three-month mRS score was an independent determinant of long-term costs after stroke.ConclusionsWe show that 3-month mRS score plays an important role in the prediction of long-term costs after stroke. Such estimates relating to 3-month mRS categories may be valuable when undertaking health economic evaluations related to stroke care.

    Original languageEnglish
    Pages (from-to)e978-e991
    Issue number9
    Publication statusPublished - 2020 Mar 3

    Bibliographical note

    © 2020 American Academy of Neurology.

    ASJC Scopus subject areas

    • Clinical Neurology


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