[Outcome in very severe stroke]

Functional outcome after stroke with severe disability (Barthel Index<60 points) was analyzed retrospectively in one hundred patients, including seventy-three with nonhemorrhagic stroke and twenty-seven with hemorrhagic stroke admitted to our neurorehabilitation center between 1986 and 2000. Neurological deficits and functional disabilities were assessed with the Barthel Index at admission to rehabilitation and after the rehabilitation program in survivors. The rehabilitation therapy was based on the Bobath concept. Patients were not discharged until neurological and functional stability had been reached. There was no difference for age, length of stay, Barthel Index scores at admission and discharged between the groups. Gain in the Barthel Index scores between admission and discharge (p=0.005) resulted from more efficiency in the group with hemorrhagic stroke. These patients appeared to exhibit better functional gain at discharge from rehabilitation than nonhemorrhagic patients. This observation points out that long-term outcome is also better for patients who experience hemorrhagic stroke.