Article

Comprehensive rehabilitation services postacute stroke have been shown
efficacious in European trials; however, their effectiveness in everyday
practices in the United States is unknown. We compared outcomes of veteran
patients provided with comprehensive rehabilitation with those provided with
consultative rehabilitation services postacute stroke using propensity scores.
Outcomes included change in patients' physical and cognitive independence after
rehabilitation, discharge to home as opposed to other settings, and 1-yr
posthospital discharge survival. Of the 2,963 patients in the study, 683 (23.1%)
received comprehensive rehabilitation while the remaining patients received
consultative services. We found, after propensity adjustment, that those who
received comprehensive rehabilitation compared with consultative gained on
average 12.8 (95% confidence interval [CI]: 9.1 to 16.5) more points of physical
independence on a 78-point scale and gained 1.5 (95% CI: 0.8 to 2.2) more points
of cognitive independence on a 30-point scale. The likelihoods of discharge to
home from the hospital (odds ratio [OR] = 1.61, 95% CI: 1.07 to 2.44) and 1-yr
posthospital discharge survival (OR = 1.79, 95% CI: 1.25 to 2.56) were
significantly higher among those who received comprehensive rehabilitation. Among
patients hospitalized for acute stroke, comprehensive rehabilitation services are
associated with greater recovery of physical and cognitive independence, improved
home discharge likelihood, and improved 1-yr survival.

Langue : ANGLAIS