Predicting improvement in stroke patients referred for inpatient rehabilitation

An historical prospective study of prediction of improvement and final disposition of 105 patients with a stroke was carried out over a 2-year period in the rehabilitation service of a hospital providing long-term care. Patients were referred a mean of 37.8 days after the stroke, and were evaluated for total function and for mental status, perception, communication and motor ability at the time of admission and every 2 to 3 weeks thereafter. At the time of admission 26% of the patients were able to care for themselves; at the time of discharge 59% were able to do so, but 44% of these could not return home, primarily because of unfavourable social and environmental circumstances. In contrast, 35% of the patients unable to care for themselves went home because their families were willing to provide extra care. Neither the total function score nor the neurologic subtest scores at the time of admission predicted improvement. The presence of sphincter control and a lower age were the only significant predictors of improvement.