Factors influencing outcome and length of stay in a stroke rehabilitation unit. Part 2. Comparison of 318 screened and 248 unscreened patients.

A comparison of outcome and length of stay (LOS) between a control group of 248 unscreened patients (reported in Part 1) and a second group of 318 patients, medically and socially screened prior to admission, - all discharged from the same 30-bed stroke unit over a 33 month period - showed that preadmission medical, neurological, and social service screening did not improve overall outcome or reduce length of stay (LOS). A program aimed at identifying and treating perceptual and cognitive dysfunction did improve functional status and discharge disposition in patients having perceptual but not cognitive deficits. A detailed analysis of the factors influencing outcome and LOS confirmed and extended earlier findings that: 1) severe weakness on admission and long onset-admission intervals were adversely related to outcome as were the presence of perceptual or cognitive dysfunction, poor motivation, a homonymous hemianopsia, multiple neurologic deficits, and poor functional status on discharge; and 2) dysphasia, the presence of a hemisensory loss, age (under 80) and/or the presence of ASHD/hypertension/diabetes were unrelated to outcome. It was again demonstrated that most patients - even those with unfavorable prognostic signs - significantly improved after appropriate treatment programs.