Article

OBJECTIVE: To investigate the relationship between the volume of inpatient
rehabilitation therapy and mortality among patients with acute ischemic stroke,
as well as to assess whether the association varies with respect to stroke
severity. DESIGN: A retrospective study with a cohort of consecutive patients who
had acute ischemic stroke between January 1, 2008, and June 30, 2009. SETTING:
Referral medical center. PARTICIPANTS: Adults with acute ischemic stroke (N=1277)
who were admitted to a tertiary hospital. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURE: Stroke-related mortality. RESULTS: During the median follow-up
period of 12.3 months (ranging from January 1, 2008, to December 31, 2009), 163
deaths occurred. Greater volume of rehabilitation therapy was associated with a
reduced risk of all-cause and cardiovascular mortality (P for trend <.001 for
both). Compared with the first tertile, the third tertile of rehabilitation
volume was associated with a 55% lower risk of all-cause mortality (hazard ratio
[HR]=.45; 95% confidence interval [CI], .30-.65) and a 50% lower risk of
cardiovascular mortality (HR=.50; 95% CI, .31-.82). The association did not vary
with respect to stroke severity (P for interaction = .45 and .73 for all-cause
and cardiovascular mortality, respectively). CONCLUSIONS: The volume of inpatient
rehabilitation therapy and mortality were significantly inversely related in the
patients with ischemic stroke. Thus, further programs aimed at promoting greater
use of rehabilitation services are warranted.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS