Functional Status and Disability in Patients After Acute Stroke: A Longitudinal Study.

Am J Crit Care

Fidel López-Espuela is research nurse, Juan Diego Pedrera-Zamorano is head of the nursing department, Pedro Enrique Jiménez-Caballero, José María Ramírez-Moreno, and Juan Carlos Portilla-Cuenca are neurologists, Jesús María Lavado-García is vice dean of the nursing school, and Ignacio Casado-Naranjo is head of the department of neurology, Stroke Unit, Hospital San Pedro de Alcantara, Cáceres, Spain.

Published: March 2016

Background: Stroke is a major public health problem.

Objective: To use the Barthel Index to evaluate basic activities of daily living in stroke survivors and detect any predictors of functional outcome at 6 months after stroke.

Methods: In an observational longitudinal study, data were gathered on consecutive patients admitted to the comprehensive stroke unit at Hospital San Pedro de Alcantara, Cáceres, Spain. Sociodemographic and clinical data were obtained prospectively at hospital admission and during follow-up 6 months later. Information on type of stroke, score on the Barthel Index, findings from the neurological evaluation, and other relevant data were collected.

Results: Of 236 patients admitted, 175 participated in the study. Mean age was 69.60 (SD, 12.52) years, 64.6% were men, and mortality was 12.8%. Six months after experiencing a stroke, 84.8% of patients had returned to their own homes, 8.0% were institutionalized, and the others were residing at a family member's home. Scores on the Barthel Index 6 months after stroke correlated with baseline scores on the National Institute of Health Stroke Scale (r = -0.424; P < .001) and with depressive mood 6 months after stroke (r = -0.318; P < .001). Age was negatively associated with Barthel Index scores at the time of hospital discharge and 6 months after stroke.

Conclusions: Functional status 6 months after stroke was influenced by age, sex, stroke severity, type of stroke, baseline status, mood, and social risk. Comorbid conditions, socioeconomic level, and area of residence did not affect patients' functional status.

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http://dx.doi.org/10.4037/ajcc2016215DOI Listing

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