Article

OBJECTIVE: To compare the changes in functional independence measured by the FIM after specialized neurorehabilitation between patients with nontraumatic
subarachnoid hemorrhage (SAH) and patients with intracerebral hemorrhage (ICH) or
acute ischemic stroke (AIS). DESIGN: Historical cohort study comparing changes in
functional independence between patients with nontraumatic SAH and those with
ICH/AIS, using FIM scores from a local database and clinical information from the
Danish National Patient Registry. SETTING: Postacute specialized inpatient
neurorehabilitation. PARTICIPANTS: Participants (N=660) comprised patients with a
first-time nontraumatic SAH (n=212) and age-matched patients with a first-time
ICH/AIS (n=448). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Crude and
adjusted comparisons of FIM (total and item by item) measured at baseline and at
discharge. RESULTS: Patients with nontraumatic SAH were admitted with a lower
functional level compared with patients with ICH/AIS (median total FIM score, 25
[interquartile range (IQR), 18-81] vs 78.5 [IQR, 47-107]), and discharged with a
lower functional level (median total FIM score, 98 [IQR, 40-116] vs 110 [IQR,
82.5-119]), although they made more progress during neurorehabilitation (median
change in total FIM score, 27 [IQR, 4-60] vs 17 [IQR, 7-35]). Statistically,
patients with nontraumatic SAH had significantly better odds for obtaining
functional independence than did patients with ICH/AIS in 6 of the 18 FIM items:
eating (odds ratio [OR]=3.2; 95% confidence interval [CI], 1.7-5.8);
dressing-upper body (OR=2.0; 95% CI, 1.1-3.5); transfer tub/shower (OR=2.0; 95%
CI, 1.1-3.6); stair walking (OR=2.2; 95% CI, 1.3-3.7); comprehension (OR=2.3; 95%
CI, 1.3-3.9); and expression (OR=3.6; 95% CI, 2.0-6.5). CONCLUSIONS: Patients
with nontraumatic SAH made significantly more progress during
neurorehabilitation, although they were discharged with a lower level of
functional independence compared with patients with ICH/AIS. However, both
patients with nontraumatic SAH and those with ICH/AIS improved their functional
outcome significantly. Also, patients with nontraumatic SAH admitted with severe
functional outcome were shown to be capable of recovering to a moderate level of
functional independence.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
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Langue : ANGLAIS