Plasma homocysteine level and functional outcome of patients with ischemic stroke.
OBJECTIVE
To investigate the possible relationships between total plasma homocysteine level (tHcy) and functional outcome of stroke patients as evaluated by the FIM instrument.


METHODS
Retrospective chart analysis.


METHODS
Inpatient stroke rehabilitation ward of a university-affiliated referral hospital.


METHODS
Consecutive patients (N=113) presenting with acute ischemic stroke. Patients were divided into 2 groups according to their tHcy levels (< or = 15 micromol/L, >15 micromol/L) and into 3 groups according to their FIM scores (low, < or =40; moderate, 41-80; high, >80).


METHODS
Not applicable.


METHODS
The tHcy level was determined shortly after stroke onset by a high performance liquid chromatography method with fluorescence detection. Functional outcome was measured by the FIM instrument at admission and discharge. The tHcy level and FIM scores were obtained for all patients. Data outcomes were analyzed by t tests, 1-way analysis of variance, Mann-Whitney U, and Fisher exact tests, as well as by the 2 ordered polytomous logistic regression model.


RESULTS
The 2 tHcy groups were similar in demographic, stroke, and comorbidity characteristics, differing only by higher frequency of hypertension in those with a tHcy greater than 15 micromol/L (51.7% vs 80.8%, respectively, P=.01). Compared with patients who had tHcy levels at 15 micromol/L or lower and were discharged from rehabilitation being in the highest FIM score group (>80), higher tHcy levels were not associated with a discharge FIM score of less than 40 (odds ratio [OR]=.77; 95% confidence interval [CI], 0.13-4.65; P=.77) or with a better functional outcome FIM score between 40 and 80 (OR=3.71; 95% CI, 0.73-18.99; P=.11).


CONCLUSIONS
Our findings suggest that determination of tHcy level does not correlate with functional outcome in patients presenting for rehabilitation after acute ischemic stroke.
Mizrahi
Eliyahu H
EH
Department of Geriatric Rehabilitation, Sheba Medical Center, Tel Aviv, Israel. exm42@sheba.health.gov.il
Fleissig
Yehudit
Y
Arad
Marina
M
Adunsky
Abraham
A
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010351:Patient Discharge; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood* / Q000209:etiology; D000071939:Stroke Rehabilitation
D006710:Homocysteine