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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 2006 Giugno;42(2):91-6
The influence of comorbidities and complications on discharge function in stroke rehabilitation inpatients
Ferriero G. 1, Franchignoni F. 1, Benevolo E. 2, Ottonello M. 2, Scocchi M. 2, Xanthi M. 3
1 Unit of Occupational Rehabilitation and Ergonomics Salvatore Maugeri Foundation Clinica del Lavoro e della Riabilitazione IRCCS, Veruno, Novara, Italy
2 Unit of Rehabilitation Medicine Salvatore Maugeri Foundation Clinica del Lavoro e della Riabilitazione, IRCCS Genoa-Nervi, Genoa, Italy
3 Department of Physical Medicine and Rehabilitation Hygeia Hospital, Athens, Greece
Aim. The aims of this prospective study were: 1) to assess the frequency, type and severity of comorbidities (COMs) and complications (COMPLs) in acute stroke patients, according to the weighted comorbidity index (w-CI) of Liu et al. and 2 new indices, respectively COM severity index (COM-SI) and COMPL severity index (COMPL-SI); 2) to separately analyse the interference of COMs and COMPLs with functional status and recovery during stroke rehabilitation treatment; 3) to compare the ability of COM-SI and COMPL-SI to predict functional independence at discharge with that of w-CI.
Methods. Eighty-five stroke rehabilitation inpatients participated in the study. The type, incidence and severity of COM at admission and of COMPL during the whole hospital stay were studied prospectively. The Functional Independence Measure (FIM) scale was administered at both admission and discharge.
Results. About 1/3 suffered from some significant COM and another 1/3 developed COMPLs needing specific medical treatment and/or clinical monitoring. The most frequent COMs and COMPLs were cardiovascular and psychiatric/psychological diseases. The odds of having a high efficiency in the daily functional gain (FIM score) were greater for patients without any COM (3.5) and/or COMPL (4.6). Similarly, the odds of having a high FIM score at discharge were greater (3.5) for patients without COM or COMPL. The COM-SI demonstrated a higher predictive capacity of the FIM score at discharge (5%) than w-CI (4%), and COMPL-SI (1%).
Conclusion. COM-SI resulted as the most interesting predictive index of functional outcome at discharge, after accounting for the functional status at admission.