[Functional recovery and return to work in the young patient after a stroke].
BACKGROUND
There are few works that study the functional recovery of young patients after suffering cerebrovascular disease (CVD) and even fewer works that study work reincorporation. Our aim is to evaluate these two aspects in the middle term in the young adults who have suffered a stroke and also to establish the factors that can influence a better prognosis.


METHODS
Our work is a cross-sectional descriptive study of 111 patients aged between 15 and 55 years who have been discharged from our Hospital with a CVD diagnosis during the years 1999-2000. We have collected the following data from the clinical records: age, gender, type, location and reason for the CVD, vascular risk factors, complications in the process, with or without rehabilitation treatment and treatment description. By means of telephone interview, we obtained functional recovery with the Barthel Index (BI) and Modified Rankin Scale (MRS) as well as study level, marital status and pre and poststroke labor situation, loss of friends, loss of recreational activities and finally, sequels after the discharge.


RESULTS
Functional recovery for daily activities (IB >or= 90) was good in 78 % of the patients, this being 72.1 % if we assess their global handicap (MRS <or= 2). Almost 80 % of the patients were working before the stroke, however, this decreased to only 50.2 % after the stroke. We have observed better functional recovery and return to work in ischemic stroke and in patients without vascular risk factors, in both cases without statistical significance (SS). We discovered an inverse relationship between age and functional recovery, measured by IB and a direct relationship with MRS, both of them with SS. We have also found SS between IB and the MRS and in those patients who returned to work compared to those who remained in an invalid situation. A total of 22.5 % of the patients reported loss of friends after the stroke, and there was SS in those who presented worst functional recovery. Finally, 57 % left previous recreational activities, there being no change in the marital status in most of the cases.


CONCLUSIONS
Three quarter of cases achieved good functional recovery with reincorporation to work in half of the patients. Sociofamiliar integration was acceptable. As predictors of a good prognosis, we found subarachnoid hemorrhage, absence of vascular risk factors and low age when the stroke occurred.
Rodriguez
J
J
Servicio de Rehabilitación, Hospital Universitario Virgen del Rocío, Sevilla. jorgeogar@hotmail.com
Exposito
J A
JA
Salvador
J
J
Ferrand
P
P
Perez
J C
JC
del Pino
R
R
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires