Abstract
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.
Keywords
List of abbreviations:
CI (confidence interval), HR (hazard ratio), NIHSS (National Institutes of Health Stroke Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 09, 2013
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
