Functional outcome of hemorrhagic and nonhemorrhagic stroke patients after in-patient rehabilitation.

Differences in functional prognosis for patients with hemorrhagic and nonhemorrhagic strokes are unclear. The purpose of this study is to compare the functional outcome of hemorrhagic and nonhemorrhagic stroke patients after inpatient stroke rehabilitation. By retrospective review, 25 hemorrhagic stroke patients were matched with 25 nonhemorrhagic stroke patients on the basis of age and onset to admission interval. Discharge Functional Independence Measure (FIM), FIM gain, FIM efficiency, length of stay (LOS), and discharge disposition were compared. Admission FIM, gender, and comorbidities were similar between the two groups. There were no differences in discharge FIM, FIM gain, and discharge to home rates between groups. However, the hemorrhagic group had a significantly shorter LOS (31.7 v 37.6 days; P = 0.05) with higher FIM-total efficiency (0.84 v 0.60; P = 0.02). The FIM-motor scale accounted for most of the gains in efficiency (0.71 v 0.53; P = 0.05) with no significant difference in FIM-cognition efficiency between groups. Post hoc analysis revealed that onset to admission interval was a strong predictor of LOS (r = 0.62; P < 0.0001). Hemorrhagic stroke patients appear to exhibit functional gains somewhat faster than nonhemorrhagic counterparts. Confirmation of these preliminary findings must await future studies.

[1]  A. G. Fisher,et al.  Differences between persons with right or left cerebral vascular accident on the Assessment of Motor and Process Skills. , 1995, Archives of Physical Medicine and Rehabilitation.

[2]  K J Ottenbacher,et al.  Strong quasi-experimental designs for research on the effectiveness of rehabilitation. , 1995, American journal of physical medicine & rehabilitation.

[3]  T. Olsen,et al.  Outcome and time course of recovery in stroke. Part II: Time course of recovery. The Copenhagen Stroke Study. , 1995, Archives of physical medicine and rehabilitation.

[4]  S. Saeki,et al.  Association between location of the lesion and discharge status of ADL in first stroke patients. , 1994, Archives of physical medicine and rehabilitation.

[5]  T. Olsen,et al.  Compensation in recovery of upper extremity function after stroke: the Copenhagen Stroke Study. , 1994, Archives of physical medicine and rehabilitation.

[6]  C. Granger,et al.  The structure and stability of the Functional Independence Measure. , 1994, Archives of physical medicine and rehabilitation.

[7]  Y. Stern,et al.  Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[8]  Thomas Galski,et al.  Predicting Length of Stay, Functional Outcome, and Aftercare in the Rehabilitation of Stroke Patients: The Dominant Role of Higher‐Order Cognition , 1993, Stroke.

[9]  C. Granger,et al.  Relationships between impairment and physical disability as measured by the functional independence measure. , 1993, Archives of physical medicine and rehabilitation.

[10]  Diane P. Martin,et al.  A validation of the functional independence measurement and its performance among rehabilitation inpatients. , 1993, Archives of physical medicine and rehabilitation.

[11]  P. Duncan,et al.  Measurement of Motor Recovery After Stroke: Outcome Assessment and Sample Size Requirements , 1992, Stroke.

[12]  R. Fogelholm,et al.  Primary intracerebral haemorrhage in the Jyväskylä region, central Finland, 1985-89: incidence, case fatality rate, and functional outcome. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[13]  J. Bamford,et al.  Clinical examination in diagnosis and subclassification of stroke , 1992, The Lancet.

[14]  J. Hopper,et al.  Acute stroke outcome: effects of stroke type and risk factors. , 1992, Australian and New Zealand journal of medicine.

[15]  Mysiw Wj,et al.  Prospective cognitive assessment of stroke patients before inpatient rehabilitation. The relationship of the Neurobehavioral Cognitive Status Examination to functional improvement. , 1989 .

[16]  M. Reding,et al.  Rehabilitation outcome following initial unilateral hemispheric stroke. Life table analysis approach. , 1988, Stroke.

[17]  L. Cushman,et al.  Secondary neuropsychiatric complications in stroke: implications for acute care. , 1988, Archives of physical medicine and rehabilitation.

[18]  R F Harvey,et al.  Computerized tomography head scans as predictors of functional outcome of stroke patients. , 1988, Archives of physical medicine and rehabilitation.

[19]  R. D'Agostino,et al.  Factors influencing survival and need for institutionalization following stroke: the Framingham Study. , 1988, Archives of physical medicine and rehabilitation.

[20]  T. Novack,et al.  Prediction of stroke rehabilitation outcome from psychologic screening. , 1987, Archives of physical medicine and rehabilitation.

[21]  R. Lipton,et al.  Intracerebral haemorrhage: a model for the prediction of outcome. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[22]  L. Jongbloed Prediction of function after stroke: a critical review. , 1986, Stroke.

[23]  G. Boysen,et al.  Prognosis for Patients Treated Conservatively for Spontaneous Intracerebral Hematomas , 1984, Stroke.

[24]  M. Kotila,et al.  The Profile Of Recovery From Stroke And Factors Influencing Outcome , 1984, Stroke.

[25]  Yang Wc,et al.  Stroke rehabilitation: correlation and prognostic value of computerized tomography and sequential functional assessments. , 1984 .

[26]  D. Wade,et al.  Stroke: influence of patient's sex and side of weakness on outcome. , 1984, Archives of physical medicine and rehabilitation.

[27]  P. Wolf,et al.  The Pilot Stroke Data Bank: Definition, Design, and Data , 1984, Stroke.

[28]  I. Steiner,et al.  The Prognostic Value of the CT Scan in Conservatively Treated Patients With Intracerebral Hematoma , 1984, Stroke.

[29]  V. Mills,et al.  Functional differences in patients with left or right cerebrovascular accidents. , 1983, Physical therapy.

[30]  P. Laycock,et al.  Stroke: does side matter? , 1982, Rheumatology and rehabilitation.

[31]  Miller Ls,et al.  Computed tomography: its potential as a predictor of functional recovery following stroke. , 1979, Archives of physical medicine and rehabilitation.

[32]  Bourestom Nc Predictors of long-term recovery in cerebrovascular disease. , 1967 .