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Title: | Five-year mortality and related prognostic factors after inpatient stroke rehabilitation: A European multi-centre study | Authors: | De Wit, Liesbet Putman, Koen Devos, Hannes Brinkmann, Nadine Dejaeger, Eddy De Weerdt, Willy Jenni, Walter Lincoln, Nadina Schuback, Birgit Schupp, Wilfried LESAFFRE, Emmanuel |
Issue Date: | 2012 | Publisher: | FOUNDATION REHABILITATION INFORMATION | Source: | JOURNAL OF REHABILITATION MEDICINE, 44 (7), p. 547-552 | Abstract: | Objective: To determine 5-year mortality and its association with baseline characteristics and functional status 6 months post-stroke for patients who received inpatient rehabilitation. Design: A prospective rehabilitation-based cohort study. Subjects: A total of 532 consecutive stroke patients from 4 European rehabilitation centres. Methods: Predictors were recorded on admission. Barthel Index was assessed at 6 months (BI6mths) and patients were followed for 5 years post-stroke. Survival probability was computed using Kaplan-Meier analysis and compared across 3 BI6mths-classes (0-60, 65-90, 95-100) (log-rank test). Significant independent predictors were determined using multivariate Cox regression analysis (hazard ratio (HR)). Results: Five-year cumulative risk of death was 29.12% (95% confidence interval (CI): 22.86-35.38). Age (HR= 1.06, 95% CI: 1.04-1.09), cognitive impairment (HR= 1.77, 95% CI: 1.21-2.57), diabetes mellitus (HR= 1.68, 95% CI: 1.16-2.41) and atrial fibrillation (HR= 1.52, 95% CI: 1.08-2.14) were independent predictors of increased mortality. Hyperlipidaemia (HR=0.66, 95% CI: 0.46-0.94), and higher BI6mths (HR=0.98, 95% CI: 0.97-0.99) were independent predictors of decreased mortality. Five-year survival probability was 0.85(95% CI: 0.80-0.89) for patients in BI6mthsclass: 95-100, 0.72 (95% CI: 0.63-0.79) in BI6mths-class: 65-90 and 0.50 (95% CI: 0.40-0.60) in BI6mths-class: 0-60 (p<0.0001). Conclusion: Nearly one-third of rehabilitation patients died during the first 5 years following stroke. Functional status at 6 months was a powerful predictor of long-term mortality. Maximum functional independence at 6 months post-stroke should be promoted through medical interventions and rehabilitation. Future studies are recommended to evaluate the direct effect of rehabilitation on long-term survival. | Notes: | [De Wit, Liesbet; Putman, Koen] Vrije Univ Brussel, Dept Med Sociol & Hlth Sci, Fac Med & Pharm, BE-1090 Brussels, Belgium. [De Wit, Liesbet; Devos, Hannes; De Weerdt, Willy] Katholieke Univ Leuven, Dept Rehabil Sci, Fac Kinesiol & Rehabil Sci, B-3001 Heverlee, Belgium. [Brinkmann, Nadine; Schupp, Wilfried] Fachklin Herzogenaurach, Herzogenaurach, Germany. [Dejaeger, Eddy] Univ Hosp Pellenberg, Pellenberg, Belgium. [Jenni, Walter; Schuback, Birgit] RehaClin Zurzach, Bad Zurzach, Switzerland. [Lincoln, Nadina] Univ Nottingham, Inst Work Hlth & Org, Nottingham NG7 2RD, England. [Lesaffre, Emmanuel] Katholieke Univ Leuven, L BioStat, Louvain, Belgium. [Lesaffre, Emmanuel] Univ Hasselt, Louvain, Belgium. [Lesaffre, Emmanuel] Erasmus MC, Dept Biostat, Rotterdam, Netherlands. | Keywords: | Rehabilitation; Sport Sciences; follow-up study; stroke; rehabilitation; prognosis; mortality;follow-up study; stroke; rehabilitation; prognosis; mortality | Document URI: | http://hdl.handle.net/1942/13849 | ISSN: | 1650-1977 | e-ISSN: | 1651-2081 | DOI: | 10.2340/16501977-0991 | ISI #: | 000305814900005 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2013 |
Appears in Collections: | Research publications |
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