PLAN Score for Early Stroke Outcome
Preadmission comorbidities, Level of consciousness, Age and Neurological deficit (PLAN) score. Predicts 30-day mortality, death or severe dependence (mRS 5–6) at discharge and 1-year mortality after acute ischaemic stroke from data available at admission. Score 0–25. Derived and validated in 9,847 patients in the Registry of the Canadian Stroke Network (O'Donnell 2012).
Score interpretation
Validation cohort: 30-day mortality 0.7%, mRS 5–6 at discharge 0.9%, 1-year mortality 2.1% (O'Donnell 2012).
→ Standard stroke unit care, reperfusion if eligible, early rehabilitation and secondary prevention. Use to inform prognosis discussions — not to give or withhold reperfusion therapy.
30-day mortality 1.4–4.4%, mRS 5–6 at discharge 1.2–6.0%, 1-year mortality 4.5–16.2%.
→ Standard stroke unit care, reperfusion if eligible, early rehabilitation and secondary prevention. Use to inform prognosis discussions — not to give or withhold reperfusion therapy.
30-day mortality 7.6–29.0%, mRS 5–6 at discharge 9.8–35.8%, 1-year mortality 21.7–46.0%.
→ Stroke unit with close monitoring; early discussion of prognosis and goals of care with the patient and family; reassess after 48–72 hours. Use to inform prognosis discussions — not to give or withhold reperfusion therapy.
30-day mortality 35.4–61.2%, mRS 5–6 at discharge 43.9–73.2%, 1-year mortality 57.7–74.3%.
→ Senior review; frank, compassionate prognosis discussion; agree ceilings of treatment; involve palliative care where appropriate. Use to inform prognosis discussions — not to give or withhold reperfusion therapy.
30-day mortality 65.9%, mRS 5–6 at discharge 78.4%, 1-year mortality 83.6%.
→ Senior review; frank, compassionate prognosis discussion; agree ceilings of treatment; involve palliative care where appropriate. Use to inform prognosis discussions — not to give or withhold reperfusion therapy.
Interpretation bands for the PLAN Score. Apply clinical judgement and local guidance.
References
- O'Donnell MJ, Fang J, D'Uva C, et al. The PLAN score: a bedside prediction rule for death and severe disability following acute ischemic stroke. Arch Intern Med. 2012;172(20):1548–1556.
Related
Curated clinical cross-links plus same-class fallbacks.
- Aspirin (Loading Dose) · Antiplatelet — ACS / Ischaemic Stroke
- Alteplase (tPA) · Thrombolytic — Ischaemic Stroke / Massive PE
- Edoxaban (AF Stroke Prevention / VTE) · Direct Factor Xa Inhibitor (DOAC)
- Clopidogrel (Stroke/TIA Secondary Prevention) · Antiplatelet (P2Y12 Inhibitor)
- Dabigatran (Stroke Prevention — AF) · Direct Oral Anticoagulant — Thrombin Inhibitor
- Rivaroxaban (Stroke Prevention — AF) · Direct Oral Anticoagulant — Factor Xa Inhibitor
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.