ADL ability is essential to everyone, since it is the most basic and common activity repeatedly conducted by people in their daily life. It is not only one of the most basic indicators that reflect the living standard, but is also the main objective for post-stroke rehabilitation intervention. The BI score adopted in the present study was easy to operate, time-saving, and had features of test-retest. The ADL problems in patients can be accurately identified as soon as possible by selecting a qualified ADL scale, in order to follow correct instructions for the rehabilitation of patients, and objectively evaluate the effect of rehabilitation. Furthermore, it also helps patients with function recovery, in order to enable them to live on their own and get back to their normal life as soon as possible. In addition, it has reliability, content consistency, common validity, and a certain degree of predictive validity . Therefore, it plays an important role in the present clinical research. Moreover, it has been found in a number of studies that there was no difference in the results of BI scoring, when compared to those of other ADL evaluation indicators [8,9,10].
According to the present study, it was found that the BI score in the death group was significantly lower than that in the survival group. Furthermore, the patient fatality rates of inpatients decreased with the increase in BI score, indicating that there was a significant dose-effect relationship between these two. The AUC of the ROC curve of the 100-BI scoring was 0.794. This shows that it has a predictive value in the prognostic evaluation of patients with acute cerebral infarction.
The results of the present study are consistent with those of previous studies. According to a study on 75 stroke patients conducted by Martinsson et al. , baseline BI scores were higher in survivors after one week and three months, when compared to those in the death group. Furthermore, Rollnik et al. found that patients with a BI score of ≥40 were more likely to be discharged from the hospital, and patients with a BI score of ≥60 had shorter hospital stays . A survey on post-discharge rehabilitation in stroke patients revealed that patients with a BI score of ≥60 before discharged maintained their scores at a relatively high level six months later, and patients with a BI score of ≤40 also demonstrated no significant changes in their scores, which remained on a relatively low level six months later [13,14,15,16]. Wade’s follow-up study revealed that the lower the baseline BI score was, the higher the death rate was for stroke patients six months later, when combined with worsening body function . The ROC curve has been widely used in evaluating medical diagnostic performance . The present study found that the AUC of the ROC curve for the 100-BI score was 0.794, which was consistent with the findings of Mar et al. Furthermore, the follow-up study revealed that the AUC of the ROC curve of BI scoring for predicting the mortality rate after one year was 0.835 [19,20,21,22,23].
At present, there are few studies on the prediction accuracy of BI scoring for predicting the recent death of patients with acute cerebral infarction. The present study found that BI scoring was highly valuable as a scoring system in prognostic prediction on patients with acute cerebral infarction. Due to the fact that the scale evaluation was largely influenced by subjective factors, sometimes the prognostic evaluation cannot reply solely on the detailed scoring of the nervous system in clinical practice. Hence, other situations should be taken into account. In addition, the examinees selected for the present study were patients with an onset within three days. Therefore, bias might exist in terms of comparison. Taking into account the fact that the condition of patients with cerebral infarction during the acute phase was unstable, most studies are inclined to the view that the evaluation on patients should last for several days, or even longer . Therefore, prospective studies with larger sample sizes are needed to verify this.