ArticleFunctional recovery following rehabilitation after hemorrhagic and ischemic stroke1☆,
Section snippets
Methods
Using electronic hospital admission and billing databases, we retrospectively identified all persons with a diagnosis of stroke who were consecutively admitted to Spaulding Rehabilitation Hospital (Boston, MA) between January 1, 1996 and December 31, 1999. All medical records were reviewed by a trained research assistant and stroke neurologist (PJK, SS), and relevant clinical, demographic, and FIM information was extracted. The stroke category (infarct, hemorrhage), stroke location
Patient sample
Baseline characteristics of the study sample are presented in table 1. A total of 1064 cases were identified that fulfilled inclusion criteria (871 with cerebral infarction, 193 with ICH; 545 women, 519 men). For both cerebral infarction and ICH subgroups, 85% of strokes in each category were located in the supratentorial compartment. Overall, the mean age was significantly lower (P<.001) and the mean rehabilitation hospital LOS significantly longer (P=.05) in the ICH subgroup compared with
Discussion
The present findings support and extend previous studies on functional outcome after ischemic and hemorrhagic stroke.5, 17, 22, 23, 24 The present study also provides new information on the degree of recovery in survivors of ICH, particularly those most severely affected by their stroke. Overall, when compared with patients with cerebral infarction, patients with ICH had more functional impairment at admission for inpatient rehabilitation therapy, made greater gains during rehabilitation, and
Conclusion
These results provide new information concerning the interaction between severity of functional impairment and stroke mechanism in determining recovery after stroke. Our findings may assist efforts to rationally triage specific subgroups of patients for different levels of rehabilitation therapy after acute hospital care.
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Cited by (0)
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Supported by the Clinical Investigator Training Program, Harvard/MIT Health Sciences and Technology - Beth Israel Deaconess Medical Center, in collaboration with Pfizer Inc; the American Heart Association, New England Affiliate; a Clinical Scientist Development Award, the Doris Duke Charitable Foundation; a Junior Faculty Award, Hartford Foundation for Excellence in Geriatric Research; and the Arthur Merrill and the Esther U. Sharp Memorial Fund.
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.