TY - JOUR
T1 - Predicting stroke inpatient rehabilitation outcome
T2 - The prominent role of neuropsychological disorders
AU - Paolucci, Stefano
AU - Antonucd, Gabriella
AU - Gialloreti, Leonardo Emberti
AU - Traballesi, Marco
AU - Lubich, Sergio
AU - Protest, Luca
AU - Palombi, Leonardo
PY - 1996
Y1 - 1996
N2 - This study was designed to determine the role of demographic, medical and cognitive factors in the results of rehabilitation in first stroke patients. In a prospective study on 273 consecutive patients admitted to a rehabilitation hospital for sequelae of first stroke, we used multiple regressions to assess the relationship between 11 independent variables and a battery of outcome measures: mortality, length of hospital stay, Barthel Index (BI) and Rivermead Mobility Index (RMI) scores at discharge and their effectiveness. Severity of stroke at admission and hemineglect were the strongest prognostic factors. In a logistic model, cognitive impairment was a significant independent predictor (OR = 4.10) also after adjusting for age and severity of stroke. Patients with hemineglect had a significantly higher relative risk of poor autonomy [RR = 7.30, 95% confidence interval (CI) 4.04-13.18] and impaired mobility (RR = 9.25, CI 4.63-18.45). Global aphasic patients had similar risks for both autonomy (RR = 4.51, CI 2.74-7.41) and mobility (RR = 4.71, CI 2.79-7.97). This study underlines the crucial role of cognitive disorders as predictors of poor functional outcome in stroke survivors and confirms the need for early neuropsychological screening.
AB - This study was designed to determine the role of demographic, medical and cognitive factors in the results of rehabilitation in first stroke patients. In a prospective study on 273 consecutive patients admitted to a rehabilitation hospital for sequelae of first stroke, we used multiple regressions to assess the relationship between 11 independent variables and a battery of outcome measures: mortality, length of hospital stay, Barthel Index (BI) and Rivermead Mobility Index (RMI) scores at discharge and their effectiveness. Severity of stroke at admission and hemineglect were the strongest prognostic factors. In a logistic model, cognitive impairment was a significant independent predictor (OR = 4.10) also after adjusting for age and severity of stroke. Patients with hemineglect had a significantly higher relative risk of poor autonomy [RR = 7.30, 95% confidence interval (CI) 4.04-13.18] and impaired mobility (RR = 9.25, CI 4.63-18.45). Global aphasic patients had similar risks for both autonomy (RR = 4.51, CI 2.74-7.41) and mobility (RR = 4.71, CI 2.79-7.97). This study underlines the crucial role of cognitive disorders as predictors of poor functional outcome in stroke survivors and confirms the need for early neuropsychological screening.
KW - Aphasia
KW - Hemi-neglect
KW - Rehabilitation
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=0029850366&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029850366&partnerID=8YFLogxK
M3 - Article
C2 - 8954308
AN - SCOPUS:0029850366
VL - 36
SP - 385
EP - 390
JO - European Neurology
JF - European Neurology
SN - 0014-3022
IS - 6
ER -