Disability and use of rehabilitation services following stroke in Rochester, Minnesota, 1975-1979.

Abstract

Medical records of all residents of Rochester, Minnesota, who had a first stroke in 1975-1979 were reviewed to determine level of disability, disposition, and use of rehabilitation services. Of the 292 persons with a first stroke, 251 (86%) (mean age 70 years) survived > 1 week. The mean Rankin disability score (Grade 1, no disability, through Grade 5, severe disability) changed from 1.7 before stroke to 2.8 in survivors at hospital discharge; 29% of those discharged required further institutional care. The level of disability in survivors remained relatively constant from 6 months after stroke through 5 years of observation. Of the 112 patients with an admission score of 5,40 (36%) were alive at 1 year and only 5 of those (13%) improved to relative independence (Rankin scores of 1 or 2). The most common comorbidity contributing to disability was cardiovascular disease (31%). After the first 18 months, the mortality in patients with stroke was similar to that in a normal population having the same age and sex distribution. Of the 2511-week survivors, 132 (53%) had rehabilitation (

Sex Differences in Long-Term Outcomes After Stroke

“…9,13,21,22 All studies adjusted for age, 2 adjusted for stroke severity, 21,22 and 2 adjusted for vascular risk factors. 13,21 Among studies not designed to examine sex differences, 5 reported that females had worse outcome than males in unadjusted analyses 10 and independent of age, 11,16,23,24 stroke severity, 23,24 prestroke disability, 23 comorbidities, 24 depression, 11 living alone, 11 recurrent stroke, 11 and cognitive impairments. 11 In contrast, others reported no association between sex and long-term functional outcomes in unadjusted analyses 11,12,20 or after adjusting for age, 16,18,[25][26][27][28][29][30][31] socioeconomic factors, 29 stroke severity, 17,18,25-27,29 -31 prestroke disability, 16,25,27 treatment, 27 mood, 18 and comorbidities.…”

Impact of Comorbidities on Ischemic Stroke Outcomes in Women

“…6 Similarly, a larger number of comorbidities correlated with poorer mRS scores 1 year poststroke in patients at the Mayo Clinic. 10 These data suggest that functional outcome measures in stroke studies may need to be adjusted for prestroke comorbidities.…”

Preventing Ischemic Stroke in Patients With Prior Stroke and Transient Ischemic Attack

“…10 More than 50% of stroke survivors have significant residual physical disability and functional impairment. 12 Stroke recurrence not only may add to physical impairment and disability but may also increase mortality and length of hospital stay. 7 In addition, stroke recurrence may lead to vascular dementia or may be an important trigger for dementia in the elderly.…”