OBJECTIVE: To compare outcomes following stroke rehabilitation among patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) versus patients with neither RA nor SLE (non-RA/SLE). METHODS: We conducted a retrospective analysis using a national database of patients with stroke admitted to inpatient rehabilitation between 1994 and 2001. Primary outcomes were discharge disposition and functional status, rated by the Functional Independence Measure (FIM) Instrument, at discharge and at followup. The independent variable was RA or SLE. Covariates were age, sex, race/ethnicity, admission FIM ratings, additional comorbidities (none, 1-3, and >3), type of stroke, and length of stay. RESULTS: We studied 47,853 patients with stroke, 368 with RA, and 119 with SLE. Discharge dispositions were similar for patients with RA and non-RA/SLE (81% discharged home). At discharge, the average FIM rating for patients with RA was 85.8, compared with 87.8 for non-RA/SLE patients. At followup, the average FIM rating for patients with RA was 95.9, compared with 99.6 for non-RA/SLE patients. RA was associated with lower FIM ratings at discharge and followup in multivariate analyses. SLE was associated with younger age (17.5 years). However, patients with SLE had similar discharge dispositions and FIM ratings to non-RA/SLE patients. CONCLUSION: RA was associated with lower functional status ratings at discharge and followup. Outpatient therapy for patients with RA may reduce long-term assistance. Patients with SLE were younger, but had similar functional outcomes to patients without RA/SLE, suggesting early morbidity from stroke among patients with SLE.
OBJECTIVE: To compare outcomes following stroke rehabilitation among patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) versus patients with neither RA nor SLE (non-RA/SLE). METHODS: We conducted a retrospective analysis using a national database of patients with stroke admitted to inpatient rehabilitation between 1994 and 2001. Primary outcomes were discharge disposition and functional status, rated by the Functional Independence Measure (FIM) Instrument, at discharge and at followup. The independent variable was RA or SLE. Covariates were age, sex, race/ethnicity, admission FIM ratings, additional comorbidities (none, 1-3, and >3), type of stroke, and length of stay. RESULTS: We studied 47,853 patients with stroke, 368 with RA, and 119 with SLE. Discharge dispositions were similar for patients with RA and non-RA/SLE (81% discharged home). At discharge, the average FIM rating for patients with RA was 85.8, compared with 87.8 for non-RA/SLEpatients. At followup, the average FIM rating for patients with RA was 95.9, compared with 99.6 for non-RA/SLEpatients. RA was associated with lower FIM ratings at discharge and followup in multivariate analyses. SLE was associated with younger age (17.5 years). However, patients with SLE had similar discharge dispositions and FIM ratings to non-RA/SLEpatients. CONCLUSION:RA was associated with lower functional status ratings at discharge and followup. Outpatient therapy for patients with RA may reduce long-term assistance. Patients with SLE were younger, but had similar functional outcomes to patients without RA/SLE, suggesting early morbidity from stroke among patients with SLE.
Authors: P M Smith; S B Illig; R C Fiedler; B B Hamilton; K J Ottenbacher; R C Fielder Journal: Arch Phys Med Rehabil Date: 1996-05 Impact factor: 3.966
Authors: Kenneth J Ottenbacher; Pamela M Smith; Sandra B Illig; Richard T Linn; Vera A Gonzales; Glenn V Ostir; Carl V Granger Journal: Med Care Date: 2003-02 Impact factor: 2.983
Authors: John G Hanly; Qiuju Li; Li Su; Murray B Urowitz; Caroline Gordon; Sang-Cheol Bae; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Sasha Bernatsky; Ann E Clarke; Daniel J Wallace; David A Isenberg; Anisur Rahman; Joan T Merrill; Paul Fortin; Dafna D Gladman; Ian N Bruce; Michelle Petri; Ellen M Ginzler; M A Dooley; Kristjan Steinsson; Rosalind Ramsey-Goldman; Asad A Zoma; Susan Manzi; Ola Nived; Andreas Jonsen; Munther A Khamashta; Graciela S Alarcón; Winn Chatham; Ronald F van Vollenhoven; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; Manuel Ramos-Casals; S Sam Lim; Murat Inanc; Kenneth C Kalunian; Soren Jacobsen; Christine A Peschken; Diane L Kamen; Anca Askanase; Chris Theriault; Vernon Farewell Journal: Arthritis Care Res (Hoboken) Date: 2018-09-01 Impact factor: 4.794