PURPOSE: Analyse racial disparities in clinical outcomes after stroke in inpatient rehabilitation facilities (IRF). METHODS: Analyses based on data from a multi-center prospective observational cohort study on inpatient stroke rehabilitation in six IRFs from across the United States. Multivariate models examined racial disparities in functional outcomes upon discharge, taking into account patient characteristics and detailed information on processes of care. RESULTS: In the moderate stroke group (N = 397), functional scores on admission were not significantly different between African-Americans and whites. In the severe stroke group (N = 335), whites showed significantly lower functional scores at admission [Functional Independence Measurement, (FIM)], mean scores, 44 versus 49 for African-Americans, p < 0.001). Multivariate analyses predicting discharge motor FIM score found no significant differences between African-American and white stroke patients (p = 0.2194 and p = 0.3547 in the moderate and severe stroke group, respectively). CONCLUSION: Controlling for patient characteristics, therapy intensity and processes of care results in non-significant differences between African-Americans and whites in motor FIM scores upon discharge. The absence of significant differences in recovery while patients were on the rehabilitation unit suggests that racial disparities in long-term functional recovery after stroke are likely to have originated before or after the inpatient rehabilitation stay.
PURPOSE: Analyse racial disparities in clinical outcomes after stroke in inpatient rehabilitation facilities (IRF). METHODS: Analyses based on data from a multi-center prospective observational cohort study on inpatient stroke rehabilitation in six IRFs from across the United States. Multivariate models examined racial disparities in functional outcomes upon discharge, taking into account patient characteristics and detailed information on processes of care. RESULTS: In the moderate stroke group (N = 397), functional scores on admission were not significantly different between African-Americans and whites. In the severe stroke group (N = 335), whites showed significantly lower functional scores at admission [Functional Independence Measurement, (FIM)], mean scores, 44 versus 49 for African-Americans, p < 0.001). Multivariate analyses predicting discharge motor FIM score found no significant differences between African-American and white strokepatients (p = 0.2194 and p = 0.3547 in the moderate and severe stroke group, respectively). CONCLUSION: Controlling for patient characteristics, therapy intensity and processes of care results in non-significant differences between African-Americans and whites in motor FIM scores upon discharge. The absence of significant differences in recovery while patients were on the rehabilitation unit suggests that racial disparities in long-term functional recovery after stroke are likely to have originated before or after the inpatient rehabilitation stay.
Authors: Suzanne Perea Burns; Brandi M White; Gayenell Magwood; Charles Ellis; Ayaba Logan; Joy N Jones Buie; Robert J Adams Journal: Disabil Rehabil Date: 2018-03-23 Impact factor: 3.033
Authors: Charles Ellis; Hyacinth I Hyacinth; Jamie Beckett; Wuwei Feng; Marc Chimowitz; Bruce Ovbiagele; Dan Lackland; Robert Adams Journal: Stroke Res Treat Date: 2014-06-15
Authors: Janet K Freburger; George M Holmes; Li-Jung E Ku; Malcolm P Cutchin; Kendra Heatwole-Shank; Lloyd J Edwards Journal: Arch Phys Med Rehabil Date: 2011-08 Impact factor: 3.966