Rehabilitation of the post-cardiac surgery stroke patient: analysis of cognitive and functional assessment.
OBJECTIVE
Determine whether, as expected, patients sustaining post-cardiac surgery stroke (PCS) (n = 19) differ from other stroke (OS) patients (n = 216).


METHODS
A total of 235 stroke patients were surveyed. Therapist ratings of Functional Independence Measure (FIM) on admission to and discharge from a rehabilitation unit were compared. Cooperation with formal neuropsychologic evaluation was assessed.


METHODS
The rehabilitation unit of a tertiary care hospital.


METHODS
Medical records for consecutive stroke patients were reviewed (January 1994 to December 1995). Groups did not differ in age, gender, or admission FIM.


METHODS
Standardized neuropsychologic evaluation of seven cognitive domains was attempted for each patient referred to the neuropsychology service. All of the patients received FIM ratings on admission to and discharge from the rehabilitation unit.


METHODS
Gain in FIM per week of rehabilitation unit stay (FIM efficiency) and discharge destination.


RESULTS
Contrary to expectations, PCS patients did not differ significantly from OS patients in FIM efficiency or discharge destination. However, PCS patients were significantly less able to cooperate with formal neuropsychologic testing, possibly secondary to their physical condition, higher-level cognitive deficits, or both.


CONCLUSIONS
Although PCS patients may sustain medical and cognitive deficits that interfere with exhaustive neuropsychologic evaluation, these deficits do not significantly interfere with functional progress in rehabilitation and should not make PCS patients ineligible for rehabilitation services.
Oden
K E
KE
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
Kevorkian
C G
CG
Levy
J K
JK
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000534:rehabilitation*; D003071:Cognition; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018579:Patient Selection; D012017:Referral and Consultation; D012189:Retrospective Studies; D016896:Treatment Outcome