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Does Race Influence Functional Outcomes in Patients with Acute Stroke Undergoing Inpatient Rehabilitation?

Rabadi, Meheroz H. MD, MRCPI, FAAN; Rabadi, Freny M. BSc (Hons); Hallford, Gene MA; Aston, Christopher E. PhD

American Journal of Physical Medicine & Rehabilitation: May 2012 - Volume 91 - Issue 5 - p 375–386
doi: 10.1097/PHM.0b013e318246635b
CME Article • 2012 Series • Number 4
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Objective Race has been shown to affect stroke-related morbidity and mortality. The purpose of this study was to determine the influence of race on rehabilitation functional outcomes in patients with an acute stroke admitted to a designated stroke rehabilitation unit.

Design A 2-yr prospective study was conducted of 670 patients admitted to an acute stroke rehabilitation unit within 30 days after an acute stroke. Demographic data along with admission and discharge Functional Independence Measure scores were recorded in a computerized stroke database. Patients participated in a standardized rehabilitation program 5 days a week for a length of stay dependent upon their individual needs.

Results The distribution of patients by race was 504 whites, 115 blacks, 38 Hispanics, and 13 Asians. The mean age of the study population was 70 yrs. Whites had a higher prevalence of atrial fibrillation, and blacks, Hispanics, and Asians had a higher prevalence of hypertension and diabetes mellitus. The primary and secondary functional rehabilitation outcomes were similar for all four groups after similar intensity of therapy (3.5 hrs daily).

Conclusions This study suggests that race does not influence rehabilitation functional outcomes in patients with acute stroke undergoing rehabilitation for the same intensity of therapy if admitted soon after their acute stroke.

From the Stroke Service Burke Rehabilitation Hospital, an affiliate of Weill Medical College of Cornell University (MHR, FMR); and Department of Pediatrics (GH, CEA), University of Oklahoma Health Sciences Center, Oklahoma City.

CME Objectives: Upon completion of this article the reader should be able to understand the effect of racial differences on: 1) incidence of stroke risk factors; 2) functional outcome in stroke patients following rehabilitation; 3) length of stay and discharge disposition in stroke patients following rehabilitation.

Level: Advanced

Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

All correspondence and requests for reprints should be addressed to: Meheroz H. Rabadi, MD, MRCPI, FAAN, Veterans Affairs Medical Center, 921 NE 13th Street, Oklahoma City, OK, 73104.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2012 Lippincott Williams & Wilkins, Inc.