[Prognosis of social reintegration following stroke]

From the socio-economic point of view, early prediction of outcome after stroke is of essential value. The longterm prognosis of 310 patients suffering from ischemic stroke, was therefore investigated by means of questionnaires. The mean follow-up period was 62.5 (S.D. 21.9) months. The results of patients who had suffered cerebrovascular accidents other than ischemic stroke or only transient ischemic attacks were not included. It had been the aim of the study to determine the predictive value of some clinical variables and symptoms in the subacute stage as regards the familial and social functioning handicaps to be expected later on. Between the number of strokes as well as the severity of some clinical signs (motor deficits, sensory deficits, speech disorders, organic mental syndrome) on the one hand, and the restrictions experienced in familial functioning on the other hand, a clear cut correlation was found. As regards social functioning, two additional predictors of unfavourable outcome could be identified: age, and lesion within the left hemisphere. The findings indicate that some clinical variables and symptoms in the subacute stage are of great predictive value concerning the ensuing handicap in familial and social functioning. These variables may help to develop individual strategies as regards the further social management and support (e.g. discharge arrangements, care services, rehabilitation programs).