Ratha Krishnan Rathi, Yeo Edgar Quan Yi, Lim Chien Joo, Chua Karen Sui Geok
Centre of Rehabilitation Excellence (CORE), Tan Tock Seng Hospital Rehabilitation Centre, Singapore 569766, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
Life (Basel). 2022 Aug 23;12(9):1295. doi: 10.3390/life12091295.
The aims of this study were to compare inpatient rehabilitation outcomes between acute stroke subtypes of Cerebral Infarction (CI) and Intracerebral Hemorrhage (ICH), and to determine the predictors of discharge outcomes. A retrospective study of stroke inpatients was carried out using the discharge Functional Independence Measure (FIM) as the primary outcome measure. Relationships between stroke subtype, rehabilitation impairments, and medical complications on FIM -gain were analyzed. Altogether, 280 datasets including 211 (75.4%) CI and 69 (24.6%) ICH were analyzed. ICH patients were significantly younger than CI patients (55 years ICH vs. 64.0 years CI years, p < 0.001), had a 10-fold higher proportion needing ICU admission (ICH 82.6% vs. CI 7.6%, p < 0.001), and had significantly lower total admission FIM scores (67 points ICH vs. 74 CI points, p = 0.006), with lower motor-FIM scores in particular (38 points ICH vs. 48 points CI, p = 0.003). Significant functional improvements after inpatient rehabilitation, i.e., FIM gain, occurred regardless of stroke subtype (FIM-ICH Δ 27 vs. FIM-CI Δ 21, p = 0.05). Despite significantly worse initial stroke severity, ICH patients achieved similar functional gains, independence levels, and return-home rates compared with their CI counterparts after inpatient rehabilitation.
本研究的目的是比较脑梗死(CI)和脑出血(ICH)这两种急性卒中亚型的住院康复结局,并确定出院结局的预测因素。采用出院时功能独立性测量(FIM)作为主要结局指标,对卒中住院患者进行了一项回顾性研究。分析了卒中亚型、康复障碍和医疗并发症与FIM改善之间的关系。共分析了280个数据集,其中包括211例(75.4%)CI患者和69例(24.6%)ICH患者。ICH患者比CI患者明显年轻(ICH患者55岁,CI患者64.0岁,p<0.001),需要入住重症监护病房的比例高出10倍(ICH患者82.6%,CI患者7.6%,p<0.001),入院时FIM总分明显更低(ICH患者67分,CI患者74分,p=0.006),尤其是运动FIM评分更低(ICH患者38分,CI患者48分,p=0.003)。住院康复后出现了显著的功能改善,即FIM改善,无论卒中亚型如何(FIM-ICH增加27分,FIM-CI增加21分,p=0.05)。尽管初始卒中严重程度明显更差,但ICH患者在住院康复后与CI患者相比,在功能改善、独立水平和回家率方面取得了相似的结果。
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