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Prognostic Factors of Activity Limitation and Discharge Destination after Stroke Rehabilitation

Massucci, Maurizio MD; Perdon, Luigi MD; Agosti, Maurizio PT; Celani, Maria Grazia MD; Righetti, Enrico MD; Recupero, Egidio MD; Todeschini, Elisabetta MD; Franceschini, Marco MDon behalf of the Italian Cooperative Research (ICR2)

American Journal of Physical Medicine & Rehabilitation: December 2006 - Volume 85 - Issue 12 - p 963-970
doi: 10.1097/01.phm.0000242620.44924.1b
Research Article: Outcomes

Massucci M, Perdon L, Agosti M, Celani MG, Righetti E, Recupero E, Todeschini E, Franceschini M: Prognostic factors of activity limitation and discharge destination after stroke rehabilitation. Am J Phys Med Rehabil 2006;85:963–970.

Objective: The aim of this study was to identify predictive variables related to activity limitation and home destination of a large sample of first-time stroke patients at discharge from a rehabilitation hospital.

Design: A multicenter observational study was conducted among 1023 first-time stroke patients who were admitted to 18 different Italian inpatient rehabilitation centers between February 1999 and November 2000. Only 997 patients were considered eligible. At admission, sociodemographic and clinical data were considered as independent variables. The outcome measures evaluated the ability to become functionally independent (independence gain [Barthel Index score ≥18]) at discharge and home return.

Results: The study data suggest that independence gain is associated with an earlier rehabilitation intervention, being male, and low or absent cognitive deficit. Home return is associated with no indwelling bladder catheterization, no dysphagia, and living with a companion (roommate or family member) before the stroke.

Conclusions: In postacute stroke rehabilitation, level of cognitive impairment, bladder dysfunction and dysphagia, early diagnosis and treatment, early rehabilitation intervention, and living status (whether the person was residing with a companion before the stroke) are important criteria for outcome measurement at the time of admission. These previous characteristics will most certainly provide clinicians with useful information during the acute phase.

From the Department of Rehabilitation, Hospital of Passignano, Passignano, Italy (MM); Department of Rehabilitation, General Hospital, Cittadella, Italy (LP); Stroke Unit, Hospital of Città della Pieve, Città della Pieve, Italy (MGC, ER); Department of Geriatrics and Rehabilitation, Hospital of Parma, Parma, Italy (MF, MA); Sicilian Cooperative of Rehabilitation, Catania, Italy (ER); and the Department of Rehabilitation, Hospital of Trevi, Trevi, Italy (ET).

Partially financed by the region of Umbria (Italy) by means of funds for the regional research.

All correspondence and requests for reprints should be addressed to Marco Franceschini, MD, Department of Geriatrics and Rehabilitation, General Hospital of Parma, via Gramsci 14 - 43100 Parma, Italy.

© 2006 Lippincott Williams & Wilkins, Inc.