The Impact of Comorbidity on Rehabilitation Outcome After Ischemic Stroke

Autor: Snežana Tomašević-Todorović, Marija Milicevic, Dušica Simić-Panić, Mirjana Jovićević, Mina Cvjetkovic Bosnjak, Ksenija Boskovic, Tamara Rabi Žikić
Rok vydání: 2018
Předmět:
Stroke – rehabilitation
0209 industrial biotechnology
medicine.medical_specialty
Activities of daily living
Moždani udar – rehabilitacija
Komorbiditet
Rehabilitacija
Ishod liječenja
Oporavak funkcije
Moždani udar
medicine.medical_treatment
lcsh:Medicine
Comorbidity
02 engineering and technology
Brain Ischemia
Disability Evaluation
03 medical and health sciences
020901 industrial engineering & automation
0302 clinical medicine
Modified Rankin Scale
Activities of Daily Living
medicine
Humans
Prospective Studies
Original Scientific Papers
Rehabilitation
Treatment outcome
Recovery of function
Stroke
Prospective cohort study
business.industry
lcsh:R
Stroke Rehabilitation
Atrial fibrillation
General Medicine
Rivermead post-concussion symptoms questionnaire
medicine.disease
Treatment Outcome
Physical therapy
business
030217 neurology & neurosurgery
Zdroj: Acta clinica Croatica
Volume 57.
Issue 1.
Acta Clinica Croatica
Acta Clinica Croatica, Vol 57., Iss 1., Pp 5-15 (2018)
ISSN: 0353-9466
1333-9451
DOI: 10.20471/acc.2018.57.01.01
Popis: Comorbidity decreases survival but it still remains unknown to what extent functional recovery after ischemic stroke is affected. The aim of this research was to determine the prevalence of the most common comorbidities in patients with ischemic stroke and to examine their predictive value on the functional status and recovery. In order to obtain relevant information for this research, we conducted a prospective study over a two-year period. It included patients with acute/subacute ischemic stroke who had inhospital rehabilitation treatment in our institution. Functional status of the patients was evaluated by the following three aspects at the beginning and at the end of rehabilitation treatment: Rivermead Mobility Index was used for mobility, Barthel Index for independence in activities of daily living, and modified Rankin Scale for total disability. Modified Charlston Comorbidity Index was used to assess comorbidity. Multivariate analysis was applied to evaluate the impact of recorded comorbidities on the patient functional outcome. Independent predictors of rehabilitation success in our study were the value of modified Charlston Comorbidity Index, atrial fibrillation and myocardial infarction. Our study demonstrated that patients with more comorbidities had worse functional outcome after stroke, so it is important to consider the comorbidity status when planning the rehabilitation treatment.
Komorbiditeti smanjuju preživljavanje nakon ishemijskog moždanog udara, ali još uvijek ostaje nepoznato koliki je njihov utjecaj na funkcijski oporavak. Cilj ovoga istraživanja bio je utvrditi učestalost najčešćih komorbiditeta u bolesnika s ishemijskim moždanim udarom i ispitati njihovu prediktivnu vrijednost na funkcijski status i oporavak. U cilju dobivanja relevantnih podataka za ovu studiju proveli smo prospektivno istraživanje u razdoblju od dvije godine. Studija je uključila bolesnike s akutnim/subakutnim ishemijskim moždanim udarom koji su imali bolnički rehabilitacijski tretman u našoj ustanovi. Funkcijsko stanje bolesnika je ocijenjeno s tri aspekta na početku i na kraju rehabilitacijskog tretmana: Indeks mobilnosti Rivermead je primijenjen za mobilnost, Barthelov indeks za neovisnost u aktivnostima svakodnevnog života, a modificirana Rankinova ljestvica za ukupnu onesposobljenost. Charlstonov indeks komorbiditeta modificiran za moždani udar je primijenjen za procjenu komorbiditeta u bolesnika. Multivarijatna analiza primijenjena je za procjenu utjecaja ispitivanih komorbiditeta na funkcionalni ishod bolesnika. Nezavisni prediktori uspjeha rehabilitacije u našem istraživanju bili su vrijednost Charlstonova indeksa komorbiditeta modificiranog za moždani udar, atrijska fibrilacija i infarkt miokarda. S obzirom na to da je naše istraživanje pokazalo kako bolesnici s većim brojem komorbiditeta postižu lošiji funkcijski ishod nakon ishemijskog moždanog udara, bitno je razmotriti komorbiditetni status pri planiranju rehabilitacijskog tretmana.
Databáze: OpenAIRE
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