Günter Seidel1, Amely Röttinger2, Jürgen Lorenzen2, Detmar Kücken2, Anja Majewski3, Karsten Klose3, Christoph Terborg4, Irina Klass4, Peter Wohlmuth5, Elke Zukunft6, Ulf Debacher6. 1. Neurologie und Neurologische Frührehabilitation, Asklepios Klinik Nord, Tangstedter Landstr. 400, 22417, Hamburg, Deutschland. g.seidel@asklepios.com. 2. Neurologie und Neurologische Frührehabilitation, Asklepios Klinik Nord, Tangstedter Landstr. 400, 22417, Hamburg, Deutschland. 3. Neurologische und Fachübergreifende Frührehabilitation, Asklepios Klinikum Harburg, Hamburg, Deutschland. 4. Neurologische Klinik, Fachübergreifende Frührehabilitation und Physikalische Medizin, Asklepios Klinik St. Georg, Hamburg, Deutschland. 5. ASKLEPIOS proresearch, Hamburg, Deutschland. 6. Konzernbereich Qualität, Asklepios Kliniken Hamburg GmbH, Hamburg, Deutschland.
Abstract
BACKGROUND: Data on the long-term effects on quality of life of patients after severe stroke and discharge from early institutional rehabilitation are important for guiding the early rehabilitation phase and the further outpatient care. OBJECTIVE: Analysis of the outcome of patients following severe stroke 3 and 12 months after discharge from early neurological rehabilitation. METHODS: Analysis of the Asklepios Hamburg multicenter early stroke rehabilitation registry (ICD 10: I61, I60, I63 and OPS 8‑552). Structured interviews with documentation of disabilities using the early rehabilitation Barthel index (ERBI), modified Rankin scale (mRS) and quality of life (12-item short form health survey, SF-12). Assessment of further treatment and complications 3 and 12 months after discharge from the early rehabilitation departments by telephone interviews. RESULTS: Out of 1045 treated stroke patients 270 were enrolled between October 2015 and November 2017 and 200 and 151 patients could be followed up after 3 and 12 months, respectively. There was a significant improvement (p < 0.001) in the median ERBI (151 patients at 12 months). Factors influencing a poorer functional outcome (higher mRS) at 12 months were a higher mRS at discharge (OR 5.43 [1.18, 25.09], p = 0.03) and age (per decade OR 1.5 [1.09, 2.02]; p = 0.01). Female sex reduced the risk for a poorer outcome after 12 months (OR 0.49 [0.25, 0.96]; p = 0.04). Quality of life (SF-12) was not different over time. The mental quality of life showed no differences (p = 0.32) compared to a historical, significantly less (p<0.001) handicapped stroke collective. CONCLUSION: The surviving severe stroke patients recovered significantly up to 12 months after discharge. The mental quality of life did not differ from that of a historical less handicapped collective.
BACKGROUND: Data on the long-term effects on quality of life of patients after severe stroke and discharge from early institutional rehabilitation are important for guiding the early rehabilitation phase and the further outpatient care. OBJECTIVE: Analysis of the outcome of patients following severe stroke 3 and 12 months after discharge from early neurological rehabilitation. METHODS: Analysis of the Asklepios Hamburg multicenter early stroke rehabilitation registry (ICD 10: I61, I60, I63 and OPS 8‑552). Structured interviews with documentation of disabilities using the early rehabilitation Barthel index (ERBI), modified Rankin scale (mRS) and quality of life (12-item short form health survey, SF-12). Assessment of further treatment and complications 3 and 12 months after discharge from the early rehabilitation departments by telephone interviews. RESULTS: Out of 1045 treated strokepatients 270 were enrolled between October 2015 and November 2017 and 200 and 151 patients could be followed up after 3 and 12 months, respectively. There was a significant improvement (p < 0.001) in the median ERBI (151 patients at 12 months). Factors influencing a poorer functional outcome (higher mRS) at 12 months were a higher mRS at discharge (OR 5.43 [1.18, 25.09], p = 0.03) and age (per decade OR 1.5 [1.09, 2.02]; p = 0.01). Female sex reduced the risk for a poorer outcome after 12 months (OR 0.49 [0.25, 0.96]; p = 0.04). Quality of life (SF-12) was not different over time. The mental quality of life showed no differences (p = 0.32) compared to a historical, significantly less (p<0.001) handicapped stroke collective. CONCLUSION: The surviving severe strokepatients recovered significantly up to 12 months after discharge. The mental quality of life did not differ from that of a historical less handicapped collective.
Entities:
Keywords:
Early rehabilitation; Long-term follow-up; Prognosis; Quality of life; Stroke
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