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First-Year Outcomes after Stroke Rehabilitation: A Multicenter Study in Thailand

DOI: 10.1155/2013/595318

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Abstract:

Stroke affects the long-term quality of life and the well-being of patients and families. Stroke patients gain benefits from rehabilitation. Authors reported 1-year outcomes of stroke rehabilitation in 327 patients registered to the Thai Stroke Rehabilitation Registry. The outcomes included death rate, readmission rate, functional ability score (Barthel Index, BI), and factors affecting BI score. Of 327 patients, 214 (65.4%) had adequate follow-up data for analysis. The average age was 62.1 ± 12.5 years, and 57.9% were male. The mortality rate was 2.5% and the readmission rate was 11.2%. The number of the patients who could function independently increased from 5.5% at discharge to 22.9% and 25.5% at month 6 and month 12, respectively. The change in functional ability level of 214 patients included improvement (51.5%), deterioration (12.8%), and equivocal (35.7%). The low functional score at month 12 was significantly correlated with longer length of stay (LOS), longer onset to admission interval, and higher depression score at month-12. In conclusion, approximately half of the patients had an improvement in the disability level for at least one grade at 1-year follow-up. The low functional score by the end of the first year is associated with longer LOS during the first admission, delay in rehabilitation program, and psychological depression. 1. Introduction Stroke is one of the leading causes of mortality [1]. It is the most common cause of physical and mental disability in the elderly worldwide, particularly East Asian populations [2]. It affects the long-term quality of life and well-being for both the patients themselves and their families. Stroke patients need medical rehabilitation to enable optimal functions that will overcome the patient’s disability. A Canadian guideline in 2008 recommended that all stroke patients should receive rehabilitation therapy as soon as their medical conditions were stable [3]. Rehabilitation for stroke patients has been shown to improve functional ability of stroke survivors and to decrease burden of their families and society [4]. The outcomes of stroke and rehabilitation vary among patients. Teasell et al. revealed, the evidence-based stroke rehabilitation care which is more efficient in functional gain, had fewer complications, had lower mortality rate, and had lower need for institutionalization [5]. The median length of survival among ischemic stroke patients independent in daily living was longer than that of those who are dependent (9.7 years (95% CI 8.9 to 10.6) versus 6.0 years (95% CI 5.7 to 6.4), resp.)

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