1. Comparison between Ischemic and Hemorrhagic Strokes in Functional Outcome at Discharge from an Intensive Rehabilitation Hospital
- Author
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Emilia Salvadori, Francesca Cecchi, Monica Martini, Francesca Casamorata, Greta Insalata, Anna Poggesi, Carmen Barbato, Claudio Macchi, Ida Donnini, Catuscia Falsini, Paola Polcaro, Valentina Rinnoci, Gioele Papi, Bahia Hakiki, and Annamaria Romoli
- Subjects
Rehabilitation hospital ,medicine.medical_specialty ,functional recovery ,medicine.medical_treatment ,Clinical Biochemistry ,Stroke severity ,030204 cardiovascular system & hematology ,Hemorrhagic strokes ,Article ,rehabilitation ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,Internal medicine ,ischemic stroke ,medicine ,hemorrhagic stroke ,Stroke ,Functional recovery ,Hemorrhagic stroke ,Ischemic stroke ,Rehabilitation ,lcsh:R5-920 ,business.industry ,Retrospective cohort study ,medicine.disease ,stroke ,lcsh:Medicine (General) ,business ,030217 neurology & neurosurgery - Abstract
Comparison studies on recovery outcomes in ischemic (IS) and hemorrhagic strokes (HS) have yielded mixed results. In this retrospective observational study of consecutive IS and HS patients, we aimed at evaluating functional outcomes at discharge from an intensive rehabilitation hospital, comparing IS vs. HS, analyzing possible predictors. Modified Rankin Scale (mRS) at discharge was the main outcome. Out of the 229 patients included (mean age 72.9 ±, 13.9 years, 48% males), 81 had HS (35%). Compared with IS (n = 148), HS patients were significantly younger (75 ±, 12.5 vs. 68.8 ±, 15.4 years, p = 0.002), required longer hospitalizations both in acute (23.9 ±, 36.7 vs. 35.2 ±, 29.9 days, p = 0.019) and rehabilitation hospitals (41.5 ±, 31.8 vs. 77.2 ±, 51.6 days, p = 0.001), and had more severe initial clinical deficit (mean number of neurological impairments: 2.0 ±, 1.1 vs. 2.6 ±, 1.4, p = 0.001) and mRS scores at admission (p = 0.046). At discharge, functional status change, expressed as mRS, was not significantly different between IS and HS (F = 0.01, p = 0.902), nor was the discharge destination (p = 0.428). Age and clinical severity were predictors of functional outcome in both stroke types. On admission in an intensive rehabilitation hospital, HS patients presented a worse functional and clinical status compared to IS. Despite this initial gap, the two stroke types showed an overlapped trajectory of functional recovery, with age and initial stroke severity as the main prognostic factors.
- Published
- 2020
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