One-year follow-up in stroke patients discharged from rehabilitation hospital

Stefano Paolucci, M. G. Grasso, Gabriella Antonucci, Elio Troisi, D. Morelli, P. Coiro, M. Bragoni

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

This study was designed to evaluate functional status at a 1-year follow-up in consecutive first-stroke patients after discharge from rehabilitation hospital and to identify reliable prognostic factors associated with changes in their abilities. Functional evaluation was made of consecutive patients 1 year after discharge to their own homes. Two multiple logistic regressions (forward stepwise) were performed using both improvement and worsening of the Barthel Index score between discharge and follow-up as dependent variables. Independent variables were medical, demographic and social factors. The final sample included 157 out of 172 patients. During the follow-up, 10 patients (5.81%) died because of a new cerebrovascular event, 1 patient died of myocardial infarction, 2 patients had new strokes and 2 fractured their paretic legs. Functionally, 43.3% of the patients maintained the level they achieved during inpatient rehabilitation treatment, 23.6% improved and the remaining 33.1% worsened. Patients with hemineglect and aged ≥ 65 years had a higher probability of functional worsening (odds ratio, OR = 3.77, 95% confidence interval, CI = 1.42-10.0 and OR = 3.93, 95% CI = 1.72-8.95, respectively). Postdischarge rehabilitation (performed for 46.5% of the final sample) was significantly and positively associated with functional improvement (OR = 7.23, 95% CI = 2.89-18.05), and its absence with functional worsening (OR = 12.32, 95% CI = 4.47-37.01). In conclusion, in nearly half of the cases, functional status was still not stabilized at the time of discharge from the rehabilitation hospital. Postdischarge outpatient treatment was useful for preventing worsening of the functional ability achived during inpatient treatment and increased the possibility of further functional improvement. Age ≥ 65 years and hemineglect were predictors of functional worsening at follow-up.

Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalCerebrovascular Diseases
Volume10
Issue number1
DOIs
Publication statusPublished - 2000

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Rehabilitation
Stroke
Inpatients
Patient Discharge
Leg
Outpatients
Therapeutics
Logistic Models
Odds Ratio
Myocardial Infarction
Demography
Confidence Intervals

Keywords

  • Functional outcome
  • Hemineglect
  • Rehabilitation
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

One-year follow-up in stroke patients discharged from rehabilitation hospital. / Paolucci, Stefano; Grasso, M. G.; Antonucci, Gabriella; Troisi, Elio; Morelli, D.; Coiro, P.; Bragoni, M.

In: Cerebrovascular Diseases, Vol. 10, No. 1, 2000, p. 25-32.

Research output: Contribution to journalArticle

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abstract = "This study was designed to evaluate functional status at a 1-year follow-up in consecutive first-stroke patients after discharge from rehabilitation hospital and to identify reliable prognostic factors associated with changes in their abilities. Functional evaluation was made of consecutive patients 1 year after discharge to their own homes. Two multiple logistic regressions (forward stepwise) were performed using both improvement and worsening of the Barthel Index score between discharge and follow-up as dependent variables. Independent variables were medical, demographic and social factors. The final sample included 157 out of 172 patients. During the follow-up, 10 patients (5.81{\%}) died because of a new cerebrovascular event, 1 patient died of myocardial infarction, 2 patients had new strokes and 2 fractured their paretic legs. Functionally, 43.3{\%} of the patients maintained the level they achieved during inpatient rehabilitation treatment, 23.6{\%} improved and the remaining 33.1{\%} worsened. Patients with hemineglect and aged ≥ 65 years had a higher probability of functional worsening (odds ratio, OR = 3.77, 95{\%} confidence interval, CI = 1.42-10.0 and OR = 3.93, 95{\%} CI = 1.72-8.95, respectively). Postdischarge rehabilitation (performed for 46.5{\%} of the final sample) was significantly and positively associated with functional improvement (OR = 7.23, 95{\%} CI = 2.89-18.05), and its absence with functional worsening (OR = 12.32, 95{\%} CI = 4.47-37.01). In conclusion, in nearly half of the cases, functional status was still not stabilized at the time of discharge from the rehabilitation hospital. Postdischarge outpatient treatment was useful for preventing worsening of the functional ability achived during inpatient treatment and increased the possibility of further functional improvement. Age ≥ 65 years and hemineglect were predictors of functional worsening at follow-up.",
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