Article

Objective: To determine 5-year mortality and its association with baseline
characteristics and functional status 6 months post-stroke for patients who
received inpatient rehabilitation. Design: A prospective rehabilitation-based
cohort study. Subjects: A total of 532 consecutive stroke patients from 4
European rehabilitation centres. Methods: Predictors were recorded on admission.
Barthel Index was assessed at 6 months (BI6mths) and patients were followed for 5
years post-stroke. Survival probability was computed using Kaplan-Meier analysis
and compared across 3 BI6mths-classes (0-60, 65-90, 95-100) (log-rank test).
Significant independent predictors were determined using multivariate Cox
regression analysis (hazard ratio (HR)). Results: Five-year cumulative risk of
death was 29.12% (95% confidence interval (CI): 22.86-35.38). Age (HR = 1.06, 95%
CI: 1.04-1.09), cognitive impairment (HR = 1.77, 95% CI: 1.21-2.57), diabetes
mellitus (HR = 1.68, 95% CI: 1.16-2.41) and atrial fibrillation (HR = 1.52, 95%
CI: 1.08-2.14) were independent predictors of increased mortality.
Hyperlipidaemia (HR = 0.66, 95% CI: 0.46-0.94), and higher BI6mths (HR = 0.98,
95% CI: 0.97-0.99) were independent predictors of decreased mortality. Five-year
survival probability was 0.85 (95% CI: 0.80-0.89) for patients in BI6mths-class:
95-100, 0.72 (95% CI: 0.63-0.79) in BI6mths-class: 65-90 and 0.50 (95% CI:
0.40-0.60) in BI6mths-class: 0-60 (p < 0.0001). Conclusion: Nearly one-third of
rehabilitation patients died during the first 5 years following stroke.
Functional status at 6 months was a powerful predictor of long-term mortality.
Maximum functional independence at 6 months post-stroke should be promoted
through medical interventions and rehabilitation. Future studies are recommended
to evaluate the direct effect of rehabilitation on long-term survival.

Langue : ANGLAIS