Association of inpatient rehabilitation with functional outcome in patients with stroke receiving mechanical thrombectomy.
Association of inpatient rehabilitation with functional outcome in patients with stroke receiving mechanical thrombectomy.
复制标题
接受机械血栓切除术的中风患者住院康复与功能结果的关系。
DOI：
10.1080/01616412.2023.2167534
复制
发表时间：
2023
影响因子：
1.9
通讯作者：
Nanavati,HelyD
中科院分区：
文献类型：
--
作者：
Lin,Chen;Arevalo,Andrea;Nanavati,HelyD
缺血性卒中患者在接受机械血栓切除术（MT）后，功能结局仍然较差。对影响出院后进行住院康复治疗的患者功能结局的因素的研究有限。我们研究了缺血性卒中患者接受MT和接受急性康复治疗的90天结局相关的患者特征。MethodsThis是一项回顾性研究，研究对象为2015年至2018年在缺血性卒中事件后接受MT治疗后连续住院康复的患者（≥18岁）。通过改良兰金评分（mRS）确定90天时的功能结局。二元逻辑回归模型被用来衡量有意义的功能独立性测量（functional independence Measure，FINS）的变化与不良结局（mRS> 2）的关联。出院时血糖升高一个单位，不良结局的可能性显著降低4% [aOR = 0.96; 95%CI = 95%CI = 0.92，0.99]。入院时的死亡率[aOR = 0.95; 95%CI = 0.90，1.00]和死亡率变化[aOR = 0.97; 95%CI = 0.93，1.02]在调整后的模型中没有显著相关的不良结局。结论接受MT的缺血性卒中患者残疾程度更严重，特别是在出院时，而接受住院康复治疗的患者未来功能结局较差的几率更高。这不分年龄、性别或种族。未来的研究需要了解的机制，可以改善我们的患者群体在IRF的功能性能。
IntroductionPatients with ischemic strokes that have undergone mechanical thrombectomy (MT) can still have poor functional outcomes. Limited research exists on factors that impact functional outcomes in these patients who are discharged to inpatient rehabilitation. We examined patient characteristics correlated with 90-day outcomes in ischemic stroke patients having undergone MT and undergo acute rehabilitation.MethodsThis is a retrospective study of patients (≥18 years) who were consecutively admitted to inpatient rehabilitation after undergoing MT following an ischemic stroke event from 2015 through 2018. Functional outcomes at 90-days were determined by the modified Rankin Score (mRS). Binary logistic regression models were used to measure the association of meaningful Functional Independence Measure (FIM) change with poor-outcome (mRS >2).ResultsOut of 56 stroke patients undergoing MT, 36 had poor outcome (mRS >2) at 90-days. One unit increase in discharge FIM significantly decreased the likelihood of poor outcome by 4% [aOR = 0.96; 95% CI = 95% CI = 0.92, 0.99]. Admission FIM [aOR = 0.95; 95% CI = 0.90, 1.00] and change in FIM [aOR = 0.97; 95% CI = 0.93, 1.02] were not significantly associated poor outcome in the adjusted models.ConclusionPatients with ischemic stroke who received MT who have a worse disability, particularly at discharge, while undergoing inpatient rehabilitation have higher odds of having poor future functional outcomes. This was regardless of age, sex, or race. Future research is needed to understand the mechanisms that can improve functional performance in our patient population at the IRF.