title: Short-term functional outcome of ischemic stroke in the elderly: a comparative study of atrial fibrillation and non-atrial fibrillation patients.
abstract: The purpose of this study was to evaluate whether atrial fibrillation affects the short-term functional outcome of elderly patients with ischemic stroke, undergoing post-acute in-hospital rehabilitation. We studied 919 consecutive patients admitted for ischemic stroke rehabilitation, out of whom 19.6% were diagnosed with atrial fibrillation. The Functional outcome of atrial fibrillation (AF) and non-atrial fibrillation (Non-AF) patients were assessed by the Functional Independence Measurement scale (FIM) at admission and discharge. Data were analyzed by t-test, Chi-square test and by multiple linear regression analysis. Compared with Non-AF, patients with AF were slightly older (p<0.001), and had lower Mini-Mental State Examination (MMSE) scores (p=0.001). Discharge total FIM scores were significantly higher in Non-AF compared with AF patients (84.34 ± 29.44 vs. 79.02 ± 30.68, p=0.031). However, total and motor FIM gains at discharge were similar in the two groups. A multiple linear regression analysis showed that age (p<0.001), admission total and motor FIM (p<0.001) and MMSE score (p<0.001) emerged as the only independent predictors of total, motor and gain FIM scores at discharge. AF was not predictive, whatsoever, of adverse FIM scores (total, motor, gain) at discharge (β=-0.024, p=0.303; β=-0.019, p=-0.455 and β=-0.04, p=0.303, respectively). The finding suggests that Non-AF ischemic stroke elderly show higher total discharge FIM scores, compared with AF patients. However, both groups achieve similar FIM gains during rehabilitation period. AF should not be considered as adversely affecting the short-term rehabilitation process of such patients.
authors.affiliation: Department of Geriatric Medicine and Rehabilitation, Shmuel Harofe Hospital, Beer-Yaakov 70300, Israel; The Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel. Electronic address: eli.mizrahi@grsh.health.gov.il.
authors.forename: E H
authors.initials: EH
authors.lastname: Mizrahi
authors.forename: Y
authors.initials: Y
authors.lastname: Fleissig
authors.forename: M
authors.initials: M
authors.lastname: Arad
authors.forename: A
authors.initials: A
authors.lastname: Adunsky
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications*; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011379:Prognosis; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atrial fibrillation; Functional outcome; Ischemic stroke; Rehabilitation