TITLE:
Impact of Diabetes, Hypertension and Heart Failure on Stroke Rehabilitation Care
AUTHORS:
Eric F. Tanlaka, Jennifer Voth, Nathania Liem
KEYWORDS:
Stroke, Comorbidities, Inpatient Rehabilitation, Functional Outcomes, CHADS2 Score
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.10 No.3,
August
26,
2022
ABSTRACT: Background: Stroke patients who have multiple comorbidities at inpatient
rehabilitation admission might experience poorer outcomes than those without
comorbidities. Some differences in outcomes between these two groups may be
based on age and type of comorbidity. Materials and Methods: Retrospective
administrative data from an inpatient stroke rehabilitation unit in a
Southwestern Ontario hospital were examined to determine the independent
associations between diabetes, hypertension, and heart failure in stroke
patients and rehabilitation length of stay (LOS), functional gains in
rehabilitation, and discharge destination. We also examined the associations
between CHADS2 score and rehabilitation LOS, functional gains in
rehabilitation, and discharge destination. Results: Seven hundred and
seven cases of stroke subcategorized as experiencing mild (n = 193), moderate
(n = 454), and severe (n = 60) stroke were included in the study. Of these
patients, 16.4% (n = 116) had type 2 diabetes, 58.7% (n = 415) had
hypertension, and 5.8% (n = 41) had congestive heart failure (CHF) prior to
stroke. CHF patients were significantly (p = 0.02) older, had significantly (p
= 0.014) lower mean FIM gains and were discharged to residential care
facilities compared to non-CHF cases. A higher CHADS2 score was
significantly associated with Lower FIM gains and discharge to longer term
settings. Conclusion: Significant differences exist in the functional
gains and discharge disposition of stroke patients based on age of patient,
type of comorbidity in stroke, and CHADS2 score.