Quantification of the probability of reaching mobility independence at discharge from a rehabilitation hospital in nonwalking early ischemic stroke patients: a multivariate study.
BACKGROUND
This study was designed to quantify the probability of recovery of mobility in admission nonwalking stroke survivors.


METHODS
We evaluated 437 of 500 consecutive patients admitted for sequelae of first ischemic stroke within the first month. We performed several logistic regressions using mobility status at discharge (independence in stair climbing; walking outside and inside, without aid or supervision; walking with cane or other aid, or need for wheelchair) as dependent variable, and several independent variables, including stratification of patients according to their Barthel Index (BI) score into 6 classes (< or =10; 11-20; 21-30; 31-40; 41-50; 51-60).


RESULTS
At discharge, 4.58% of patients were independent in stair climbing, 8.70% were able to walk outside, 14.41% to walk inside, and 27.46% to walk with cane or other aid, while 44.85% remained in wheelchair. Very low BI scores at admission were associated with a high risk of need for wheelchair, whereas patients with BI score 51-60 showed a high probability to reach independence in stair climbing (OR = 5.60). Age, severity of neurological impairment, global aphasia, unilateral spatial neglect, male gender and vocational status also played a prognostic role.


CONCLUSIONS
The probability of potential mobility recovery can be quantified at admission with better accuracy for independence in stair climbing and walking outside without any aid (percentages correctly predicted 95.4 and 91.8%, respectively). Stratification of BI score may be useful to better quantify the risk for each patient.
Paolucci
Stefano
S
Fondazione IRCCS Santa Lucia, Rome, Italy. s.paolucci@hsantalucia.it
Bragoni
Maura
M
Coiro
Paola
P
De Angelis
Domenico
D
Fusco
Francesca Romana
FR
Morelli
Daniela
D
Venturiero
Vincenzo
V
Pratesi
Luca
L
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000150:complications; D002545:Brain Ischemia / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D051341:Dependent Ambulation; D005260:Female; D006757:Hospital Units; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D016017:Odds Ratio; D010351:Patient Discharge; D011379:Prognosis; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012050:Rehabilitation, Vocational; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking