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Functional outcome after inpatient rehabilitation in persons with subarachnoid hemorrhage
Michael W O'Dell1, Thomas K Watanabe, Steven T De Roos
1Department of Physical Medicine and Rehabilitation, Long Island Jewish Medical Center, New Hyde Park, NY 10021, USA. mio2005@med.cornell.edu
Objectives:
To describe inpatient rehabilitation outcome in persons with nontraumatic subarachnoid hemorrhage (SAH) and to explore the predictive capacity of acute measures of SAH severity and demographic and disease variables.
Design:
Retrospective with descriptive and relational analyses.
Setting:
Free-standing, acute, inpatient brain injury rehabilitation unit.
Participants:
Forty-two consecutive persons with nontraumatic SAH and for whom complete data were available were studied. Mean age of the group was 56.5 years, mean acute hospital stay was 26.2 days, and 60% were women. Over 40% experienced rupture of an anterior communicating artery aneurysm. The time from injury to rehabilitation admission varied from 11 to 227 days (mean, 43.8d).
Interventions:
Not applicable.
Main Outcome Measure:
Change in FIMtrade mark instrument scores, home discharge rate, and rehabilitation length of stay (LOS.)
Results:
The mean admission and discharge FIM scores were 57.7 and 85.5 points, respectively. There was a 27.8-point mean change in FIM score over a 24.1-day mean rehabilitation LOS for a FIM efficiency (points/day) of 1.15. Over 80% of the sample was discharged home. No demographic or disease characteristic variables, including acute severity measures, were statistically significant predictors of outcome.
Conclusions:
Functional gains during inpatient rehabilitation made in this group of 42 persons with SAH are in line with earlier studies. Our rehabilitation LOS is the shortest reported among 4 studies to date and is probably a reflection of managed care in the United States. A small sample, uneven cell sizes, and variability of patients might have contributed to a lack of significant findings. Future study should explore the prediction of rehabilitation outcome using larger sample sizes and longer follow-up periods.