title: ["Time is brain": only in the acute phase of stroke?].
abstract: OBJECTIVE
  In Spain, stroke is the leading cause of death in women as well as the leading cause of disability in adults. This translates into a huge human and economic cost. In recent years there have been significant advances both in the treatment of acute stroke and in the neuro-rehabilitation process; however, it is still unclear when the best time is to initiate neurorehabilitation and what the consequences of delaying treatment are. To test the effect of a single day delay in the onset of neurorehabilitation on functional improvement achieved, and the influence of that delay in the rate of institutionalisation at discharge.
  
  
  METHODS
  A retrospective study of patients admitted to Parkwood Hospital's Stroke Neurorehabilitation Unit (UNRHI) (University of Western Ontario, Canada) between April 2005 and September 2008 was performed. We recorded age, Functional Independence Measurement (FIM) score at admission and discharge, the number of days between the onset of stroke and admission to the Neurorehabilitation Unit and discharge destination.
  
  
  RESULTS
  After adjustment for age and admission FIM, we found a significant association between patient functional improvement (FIM gain) and delay in starting rehabilitation. We also observed a significant correlation between delay in initiating therapy and the level of institutionalisation at discharge.
  
  
  CONCLUSIONS
  A single day delay in starting neurorehabilitation affects the functional prognosis of patients at discharge. This delay is also associated with increased rates of institutionalisation at discharge.
authors: Unidad de Neurorrehabilitación, Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, España. manumurie@gmail.com
authors: M
authors: M
authors: Murie-Fernández
authors: S
authors: S
authors: Ortega-Cubero
authors: M
authors: M
authors: Carmona-Abellán
authors: M
authors: M
authors: Meyer
authors: R
authors: R
authors: Teasell
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D042241:Early Diagnosis; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D013030:Spain; D020521:Stroke / Q000473:pathology* / Q000628:therapy*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome