Article

Very few studies have investigated the predictive value of functional
outcome, social outcome and discharge destination in patients with
cerebrovascular accident (CVA) with aphasia. The aim of this study was to verify
whether aphasia is predictor for outcome in patients with stroke with aphasia.
METHODS: The study was carried out in 262 patients with primary diagnosis of CVA
and aphasia, included over a 6-year period (2001-2007): 131 with and 131 without
aphasia. Statistically significant variables at the univariate regression
analysis were submitted to the multivariate analysis. Backward stepwise
regression analysis was applied to predict final motor-Functional Independence
Measure (FIM), effectiveness in motor-FIM, final cognitive-FIM score and
effectiveness in cognitive-FIM and discharge destination. Independent variables
were age, gender, aphasia, stroke type, stroke lesion size, comorbidity, bladder
catheter, motor function, trunk control test, initial motor-FIM and committed
caregiver identified on admission to rehabilitation. RESULTS: Patients with
aphasia had lower motor-FIM and cognitive-FIM scores both at admission and at
discharge, if compared with those without aphasia. Effectiveness in motor-FIM and
cognitive-FIM scores was also poorer in patients with aphasia. Seventy-seven per
cent of patients with aphasia and 91.6% of patients without aphasia returned at
home. In the multivariate regression analysis, aphasia was predictor of final
motor-FIM (beta = 0.15), final cognitive FIM (beta = 0.72), effectiveness in
motor-FIM (beta = 0.17) and discharge destination (beta = 0.20). CONCLUSIONS:
Aphasia is a predicting factor of outcome and it is the most important predictor
of social outcome in patients with stroke with aphasia.

Langue : ANGLAIS