Clinical characteristics and outcome determinants of stroke rehabilitation

Abstract

Introduction: Heterogeneity of stroke outcome measures has increased the complexity of there usefulness across institutions. We sought to identify factors that determine post stroke functional outcome and discharge destination following rehabilitation. Method:Retrospective study of 482 stroke patients admitted to a rehabilitation centre between July 07 to July 12 were studied. Selection criteria included ischemic or hemorrhagic stroke with completed admission notes. Sixty-eight variables were analysed. Partition modeling was used to identify significant variables. Results:Total of 426 patients met inclusion criteria (mean age 70.67 SD = 13.31, SEM 0.645; male 58%, n=245). Mean length of rehabilitation was 48.36 d. Majority of patients were from home prior to stroke and 80% returned home, the mean length of rehabilitation was 45.22 d. A significant difference was noted in the total Functional Independence Measure (FIM) for patients who were discharged home compared to those discharged to high level residential care (HLOC)(p<0.001) or low level residential care (LLOC) (p=0.0497), and those who were discharged to LLOC compared to HLOC (p=0.0044). Total FIM ≥77, carer support, and age ≤77 y were associated with returning home. For patients with total FIMS 36-77, age <82 y and carer support were associated with returning home. HLOC was predictable if age ≥82 y, length of stay in acute hospital ≥14 d, and FIM for upper body dressing of <5. Conclusion:Total FIMS together with other predictors prior to enrolling in inpatient stroke rehabilitation would improve efficiency and patient outcomes.