1. Clinical profiles and functional outcomes in elderly stroke survivors undergoing neurorehabilitation: a retrospective cohort study
- Author
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Sergiu Albu, Elisenda Izcara López de Murillas, Mariona Secanell Espluga, Andrea Jimenez Crespo, and Hatice Kumru
- Subjects
Stroke ,Elderly ,Rehabilitation ,Functional outcomes ,Hospital length of stay ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Background This retrospective study characterizes clinical profiles and evolution of elderly stroke patients undergoing neurorehabilitation. Additionally, it identifies predictors of functional outcomes and hospital length of stay (LOS). For this purpose, patients aged ≥ 60 years admitted for neurorehabilitation within 6 months post-stroke, were recruited between January 2015 and August 2022. Rehabilitation profiles were identified using two-step clustering analysis, including the Modified Rankin Score (mRS), the National Institutes of Health Stroke Scale (NIHSS) and the motor and cognitive Functional Independence Measure (m-FIM and c-FIM) upon admission. FIM-effectiveness was calculated as (FIM-discharge−FIM-admission)/(maximum FIM−FIM-admission). Linear regression analyses were conducted to identify predictors of functional outcomes and LOS (days). Results The study enrolled 104 patients (68 male; mean age = 69.45 ± 6.5 years). Three clusters were identified: “Moderate” [NIHSS = 7.70 ± 3.21, motor-FIM = 59.42 ± 12.24, cognitive-FIM = 26.96 ± 4.69, mRS = 4 (4–4), aphasia = 41.7%, severe dysphagia = 4.2%, LOS = 45 (33.25–59) days]; “Moderate-severe” [NIHS = 10.40 ± 3.23, motor-FIM = 28.00 ± 7.74, cognitive-FIM = 25.92 ± 6.55, mRS = 4 (4–5), aphasia = 13%, severe dysphagia = 6.4%, LOS = 61 (45–92) days]; and “Severe” group [NIHS = 18.76 ± 4.19, motor-FIM = 16.12 ± 6.69, cognitive-FIM = 10.58 ± 4.14, mRS = 5 (5–5), aphasia = 60.6%, severe dysphagia = 42.4%, LOS = 71 (60.5–97.5) days]. The motor and cognitive FIM effectiveness significantly improved in the “Moderate” (m-FIM-effectiveness = 33.70 [12.16–53.54]; c-FIM-effectiveness = 33.3 [0–50.0]) and “Moderate-severe” cluster (m-FIM-effectiveness = 31.15 [10.34–46.55]; c-FIM-effectiveness = 33.3[0–63.16]) compared to the “Severe” cluster (m-FIM-effectiveness = 5.77 [0–18.77]; c-FIM-effectiveness = 4.65 [0–22.30]) (p = 0.001 and p = 0.025), whereas aphasia and dysphagia improved in all groups (p > 0.1). Severe stroke (NIHSS) (β = 0.33, p
- Published
- 2024
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