Effect of inpatient rehabilitation facility care on ninety day modified Rankin score in ischemic stroke patients.

Autor: Manchi MR; Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Stop 9055, Dallas, TX 75390, United States., Venkatachalam AM; Ross University School of Medicine Miramar, FL, United States., Atem FD; University of Texas Health Science Center at Houston School of Public Health, Dallas, TX, United States., Stone S; University of Texas Southwestern Medical Center, Dallas, TX, United States., Mathews AA; Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Stop 9055, Dallas, TX 75390, United States., Abraham AM; Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Stop 9055, Dallas, TX 75390, United States., Chavez AA; Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Stop 9055, Dallas, TX 75390, United States., Welch BG; Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States., Ifejika NL; Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Stop 9055, Dallas, TX 75390, United States; Department of Neurology, University of Texas Southwestern Medical Center, DALLAS, TX, United States. Electronic address: Nneka.Ifejika@utsouthwestern.edu.
Jazyk: angličtina
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2023 Jun; Vol. 32 (6), pp. 107109. Date of Electronic Publication: 2023 Apr 07.
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107109
Abstrakt: Objective: To determine Inpatient Rehabilitation Facility (IRF) treatment effect on modified Rankin Scale (mRS) scores at 90 days in acute ischemic stroke (AIS) patients.
Materials and Methods: This prospective cross-sectional study included 738 AIS patients admitted 1/1/2018-12/31/2020 to a Comprehensive Stroke Center with a Stroke Rehabilitation program. We compared outcomes for patients who went directly home versus went to IRF at hospital discharge: (1) acute care length of stay (LOS), (2) National Institutes of Health Stroke Scale (NIHSS) score, (3) mRS score at hospital discharge and 90 days, (4) the proportion of mRS scores ≤ 2 from hospital discharge to 90 days.
Results: Among 738 patients, 499 went home, and 239 went to IRF. IRF patients were more likely to have increased acute LOS (10.7 vs 3.9 days; t-test, P<0.0001), increased mean NIHSS score (7.8 vs 4.8; t-test, P<0.0001) and higher median mRS score (3 vs 1, t-test, P<0.0001) compared to patients who went home. At 90 days, ischemic stroke patients who received IRF care were more likely to progress to a mRS ≤ 2 (18.7% increase) compared to patients discharged home from acute care (16.3% decrease). Home patients experienced a one-point decrease in mRS at 90 days compared to those who received IRF treatment (median mRS of 3 vs. 2, t-test, P<0.05).
Conclusions: In ischemic stroke patients, IRF treatment increased the likelihood of achieving mRS ≤ 2 at 90 days indicating the ability to live independently, and decreased the likelihood of mRS decrease, compared with patients discharged directly home after acute stroke care.
Competing Interests: Declaration of Competing Interest None
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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