Open AccessPredictors of functional dependence at hospital discharge in a stroke unit
Author(s) -
Iris Maria Ribeiro Rocha,
Paola Nabhan Leonel dos Santos,
João Guilherme Bochnia Küster,
Maria Angélica Vieira Lizama,
Vinícius Riegel Giugno,
Hélio Afonso Ghizoni Teive,
Salmo Raskin
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.673
Subject(s) - medicine , stroke (engine) , modified rankin scale , relative risk , rehabilitation , polypharmacy , delirium , rehabilitation hospital , cohort , physical therapy , ischemic stroke , intensive care medicine , confidence interval , mechanical engineering , ischemia , engineering
Functional dependence is a common condition poststroke. The specialized care offered at the stroke unit can provide patients with better rehabilitation. We designed a study to evaluate risk factors for functional dependence at hospital discharge in a stroke unit. Design and setting: Prospective cohort study at Hospital Geral Roberto Santos. Methods: Patients were admitted within 72h of ictus. Functional dependence was defined as scores 3-5 on the modified Rankin Scale (mRS). Results: 389 patients were enrolled, with a mean age of 59.3 (±17.9) years, of whom 55.8% were men. The frequency of functional dependence at discharge was 57.1%, 50.3% at 30 days, and 38.8% at 90 days of the ictus. Higher risk of dependence at hospital discharge were associated with stroke recurrence [RR 1.2 (1.0 - 1.5)], polypharmacy [RR 1.3 (1.1 - 1.6)], female sex [RR 1.3 (1.1 - 1.6)], hemorrhagic stroke [RR 1.4 (1.2 - 1.7)], large artery atherosclerosis by TOAST [RR 1.6 (1.2 - 2.0)], hemorrhagic transformation [RR 1.57 (1.3 - 1.9)], infection [RR 1.7 (1.5 - 2.0)] and delirium [RR 1.8 (1.5 - 2.0)] during hospitalization. Conclusions: We have demonstrated a high frequency of functional dependence at hospital discharge from the stroke unit. Understanding which patients may have a worse functional outcome can be a good strategy to articulate access to the rehabilitation.