Functional Status and Disability in Patients After Acute Stroke: A Longitudinal Study

Abstract

Background Stroke is a major public health problem. Objective To use the Barthel Index to evaluate basic activities of daily living in stroke survivors and detect any predictors of functional outcome at 6 months after stroke. Methods In an observational longitudinal study, data were gathered on consecutive patients admitted to the comprehensive stroke unit at Hospital San Pedro de Alcantara, Cáceres, Spain. Sociodemographic and clinical data were obtained prospectively at hospital admission and during follow-up 6 months later. Information on type of stroke, score on the Barthel Index, findings from the neurological evaluation, and other relevant data were collected. Results Of 236 patients admitted, 175 participated in the study. Mean age was 69.60 (SD, 12.52) years, 64.6% were men, and mortality was 12.8%. Six months after experiencing a stroke, 84.8% of patients had returned to their own homes, 8.0% were institutionalized, and the others were residing at a family member’s home. Scores on the Barthel Index 6 months after stroke correlated with baseline scores on the National Institute of Health Stroke Scale (r = −0.424; P < .001) and with depressive mood 6 months after stroke (r = −0.318; P < .001). Age was negatively associated with Barthel Index scores at the time of hospital discharge and 6 months after stroke. Conclusions Functional status 6 months after stroke was influenced by age, sex, stroke severity, type of stroke, baseline status, mood, and social risk. Comorbid conditions, socioeconomic level, and area of residence did not affect patients’ functional status.

Multiple Chronic Conditions and Functional Outcome after Ischemic Stroke: A Systematic Review and Meta-Analysis

“…Characteristics of the hospital-based cohort studies are summarized in online supplemental Table 3. Among the 12 studies, 11 studies were prospective cohorts recruited during hospitalization [25,[39][40][41][42][43][44][45][46][47][48]. There was 1 US [39] and 1 Asian cohort [25], while the majority of cohorts were from European countries [40][41][42][43][44][45][46][47][48][49].…”

“…One study was conducted in veterans [39]. In the majority of the studies, the mean/median age of the participants was between 70 and 75 years old [40][41][42][43][44][45][46][47][48].…”

“…The median RoB total score was 4.75 points for the hospital-based cohorts (range 1 [47] -9 points [42]). Seven of the 12 studies were of high quality with low RoB [40,[43][44][45][47][48][49]. The scores of the included studies are detailed in online supplemental Table 4.…”

Association between periodontitis and ischemic stroke: a systematic review and meta-analysis

“…Stroke is the second most common cause of mortality worldwide [1,2], and it is the third leading cause of adult disability [3]. Indeed, approximately 90 % of stroke survivors are left with some residual deficits.…”

Is there a correlation between socioeconomic disparity and functional outcome after acute ischemic stroke?

“…In the Netherlands, van den BosGA et al examined a small sample of stroke patients (n = 465) and found that there was no significant association of low level of education with disability (Barthel Index and mRS) at 6 months and 5 years post-stroke [15]. A study of small sample (n = 175) in Spain reported that socioeconomic level did not affect patients' functional recovery in 6 months after stroke [16]. In Europe, Putman et al analyzed the data of 419 consecutive patients with stroke and got conflicting results: during inpatient stay, functional impairment 6 months after stroke was associated with a low educational level but not low income, and between discharge and 6 months post stroke, no significant association was found with the educational level and income [17].…”