http://www.archives-pmr.org/article/S0003-9993%2817%2930244-7/abstract
Chien-Min Chen, MDCorrespondence information about the author MD Chien-Min ChenEmail the author MD Chien-Min Chen
,
Yao-Hsu Yang, MD
,
Chia-Hao Chang, PhD
,
Pau-Chung Chen, MD, PhD
Abstract
Objective
To assess the long-term health outcomes of acute stroke survivors transferred to the rehabilitation ward.
Design
Long-term
mortality rates of first-time stroke survivors during hospitalization
were compared among the following sets of patients: patients transferred
to the rehabilitation ward (RR), patients receiving rehabilitation
without being transferred to the rehabilitation ward (NtR), and patients
receiving no rehabilitation (NoR).
Setting
We
conducted a five-year, nationwide, population-based, retrospective,
cohort study, using data from the Longitudinal Health Insurance Database
2005 in Taiwan.
Participants
A
total of 11,419 patients with stroke from 2005 to 2008 were initially
assessed for eligibility. After propensity score matching, 390
first-time stroke survivors were included.
Intervention
None.
Main Outcome Measures
The Cox proportional hazards regression model was used to assess differences in 5-year post-stroke mortality rates.
Results
Based
on adjusted hazard ratios (HR), the NtR (adjusted HR = 2.20; 95%
confidence interval (CI): 1.36–3.57) and NoR (adjusted HR = 4.00; 95%
CI: 2.55–6.27) groups had significantly higher mortality risk than the
RR group. Mortality rate of these stroke survivors was affected by age ≥
65 years (compared to age < 45 years, adjusted HR = 3.62), men
(adjusted HR = 1.49), ischemic stroke (adjusted HR = 1.55), stroke
severity (Stroke Severity Index (SSI) ≥20, compared to SSI <10,
adjusted HR = 2.68), and comorbidity (Charlson–Deyo Comorbidity Index
(CCI) ≥3, compared to CCI = 0, adjusted HR = 4.23).
Conclusions
First-time
stroke survivors transferred to the rehabilitation ward had a 5-year
mortality rate 2.2 times lower than those who received rehabilitation
without transfer to the rehabilitation ward and 4 times lower than those
who received no rehabilitation.
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