OBJECTIVE: To determine the validity of clinically derived prognostic scores in 
targeting stroke rehabilitation in elderly patients.
DESIGN, SETTING AND PARTICIPANTS: One-year prospective cohort study in 96 
hospitalized stroke patients over 75 years of age from a well defined 
geographical area.
MEASUREMENTS: Edinburgh prognostic score (incorporating measures of motor 
deficit, proprioception, and power), Orpington prognostic score (Edinburgh score 
modified to include a measure of cognition), and Barthel ADL scores were 
measured at 1, 2, and 4 weeks after stroke. These scores were correlated with 
outcome and patients' Barthel ADL score at discharge or at 16 weeks if still in 
hospital.
RESULTS: Edinburgh prognostic score measured at 2 weeks correlated significantly 
with Barthel ADL score at discharge or at 16 weeks (r2 = 0.57, P < 0.001), and 
Orpington prognostic scores showed greater correlation (r2 = 0.89 vs 0.57), 
especially in patients with dementia (r2 = 0.81 vs 0.39). Barthel ADL scores at 
2 weeks showed a weak correlation with Barthel ADL scores at discharge or 16 
weeks (r2 = 0.58). Patients with Orpington Score < 3.2 were discharged within 3 
weeks of stroke, whereas those scoring > 5.2 required long-term care. Most 
patients (90%) with Orpington Score of 3-5 were eventually discharged home 
although this was not always apparent on initial clinical assessment at the time 
of admission.
CONCLUSIONS: The Orpington score when assessed at 2-weeks post-stroke is a 
useful prognostic indicator with special suitability for the elderly and may 
help to select patients most likely to benefit from stroke unit rehabilitation.