Modified Rankin Scale

Assess degree of disability and dependence in neurological disorders. Primary outcome measure in stroke trials; guides tPA and thrombectomy eligibility (premorbid mRS).

Indication

Assess degree of disability and dependence in neurological disorders. Primary outcome measure in stroke trials; guides tPA and thrombectomy eligibility (premorbid mRS).

Criteria

id: mrs; label: Best-fit description; type: options; options: value: 0; label: 0 — No symptoms at all; value: 1; label: 1 — No significant disability; carries out all usual duties; value: 2; label: 2 — Slight disability; independent but some activities limited; value: 3; label: 3 — Moderate disability; needs some help, walks unassisted; value: 4; label: 4 — Moderately severe; cannot walk or attend needs unassisted; value: 5; label: 5 — Severe; bedridden, incontinent, constant care; value: 6; label: 6 — Dead

Interpretation

function(score) { if (score <= 1) return { risk: 'mRS ' + score, tier: 'Excellent Outcome', action: 'Functionally independent. Premorbid mRS 0\u20131 generally required for tPA consideration.', color: 'green' }; if (score === 2) return { risk: 'mRS ' + score, tier: 'Good Outcome', action: 'Minor limitations. Premorbid mRS 0\u20132 eligible for thrombectomy.', color: 'green' }; if (score === 3) return { risk: 'mRS ' + score, tier: 'Fair Outcome', action: 'Moderate disability, requires some help. Consider thrombectomy if large vessel occlusion.', color: 'yellow' }; if (score <= 5) return { risk: 'mRS ' + score, tier: 'Poor Outcome', action: 'Significant disability and dependence. Premorbid mRS \u22652 is a relative contraindication to tPA.', color: 'red' }; return { risk: 'mRS ' + score, tier: 'Death', action: 'mRS 6 indicates death.', color: 'red' }; }

Clinical pearls

mRS is the primary endpoint in virtually all major stroke trials — essential for research literacy
90-day mRS is the standard follow-up assessment point
Shift analysis (comparing the full mRS distribution) is more sensitive than dichotomized good/bad outcomes
Always record premorbid mRS before stroke to determine intervention eligibility

Source and review

Rankin J. Scott Med J 1957; van Swieten JC et al. Stroke 1988. Last reviewed: 2025-01-01