Effect of inpatient rehabilitation facility care on ninety day modified Rankin score in ischemic stroke patients

Maunica R. Manchi, Aardhra M. Venkatachalam, Folefac D. Atem, Suzanne Stone, Amy A. Mathews, Annie M. Abraham, Audrie A. Chavez, Babu G. Welch, Nneka L. Ifejika

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine Inpatient Rehabilitation Facility (IRF) treatment effect on modified Rankin Scale (mRS) scores at 90 days in acute ischemic stroke (AIS) patients. Materials and methods: This prospective cross-sectional study included 738 AIS patients admitted 1/1/2018-12/31/2020 to a Comprehensive Stroke Center with a Stroke Rehabilitation program. We compared outcomes for patients who went directly home versus went to IRF at hospital discharge: (1) acute care length of stay (LOS), (2) National Institutes of Health Stroke Scale (NIHSS) score, (3) mRS score at hospital discharge and 90 days, (4) the proportion of mRS scores ≤ 2 from hospital discharge to 90 days. Results: Among 738 patients, 499 went home, and 239 went to IRF. IRF patients were more likely to have increased acute LOS (10.7 vs 3.9 days; t-test, P<0.0001), increased mean NIHSS score (7.8 vs 4.8; t-test, P<0.0001) and higher median mRS score (3 vs 1, t-test, P<0.0001) compared to patients who went home. At 90 days, ischemic stroke patients who received IRF care were more likely to progress to a mRS ≤ 2 (18.7% increase) compared to patients discharged home from acute care (16.3% decrease). Home patients experienced a one-point decrease in mRS at 90 days compared to those who received IRF treatment (median mRS of 3 vs. 2, t-test, P<0.05). Conclusions: In ischemic stroke patients, IRF treatment increased the likelihood of achieving mRS ≤ 2 at 90 days indicating the ability to live independently, and decreased the likelihood of mRS decrease, compared with patients discharged directly home after acute stroke care.

Original languageEnglish (US)
Article number107109
JournalJournal of Stroke and Cerebrovascular Diseases
Volume32
Issue number6
DOIs
StatePublished - Jun 2023
Externally publishedYes

Keywords

  • Grotta bars
  • Inpatient rehabilitation facility
  • Ischemic stroke
  • Modified Rankin score
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Rehabilitation
  • Surgery

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