Clinical Predictors of Good Functional Outcome in Patients with Acute Stroke
Keywords:Barthel index, functional outcomes, clinical predictors, stroke, rehabilitation
Objectives: To evaluate clinical predictors related to good functional outcomes in acute phase stroke patients.
Study design: Prognostic research with prospective cohort design.
Setting: Stroke Unit, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima Province, Thailand.
Subjects: Acute stroke patients age over 18 years who were admitted for conservative treatment
Methods: Patients were interviewed face-to-face regarding general information and were physically examined for clinical predictors related to good functional outcome such as premorbid status, diagnosis, comorbid conditions, complications, neurological condition, and bed mobility ability. The Barthel index score was used to determine functional outcome at acute phase admission. The patients were later interviewed by phone to determine their Barthel index score at 2 weeks, 1 and 3 months. Statistical analysis of acute clinical predictors of good functional outcome was conducted using multivariable logistic regression.
Results: Two hundred patients were recruited of whom 6.5% were excluded from the study. The average age (SD) was 63.5 (15.2) years and 51.9% were male. At the 3-month follow-up, 82.9% of stroke-survival patients had a good functional outcome (Barthel index > 75). Clinical predictors of a good functional outcome included the ability to change the body position from supine to sitting, independent walking before admission, age less than 65 years and normal consciousness in the acute phase, with adjusted odd ratios (95% CI) of 21.63 (2.13-218.76), 15.80 (2.90-86.11), 4.95 (1.50-16.35) and 3.88 (1.65-9.16), respectively.
Conclusions: Among the stroke patients, the ability to change body position from supine to sitting, the ability to walk independently without gait aids before admission, age less than 65 years and normal consciousness in the acute phase were related to good functional outcome.
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