Rehabilitation Length of Stay in Patients Suffering from Aphasia After Stroke

Abstract

Background and Purpose: Few studies have assessed the relationship between aphasia and rehabilitation length of stay (LOS). The aim of the current prospective study was to evaluate LOS in patients with aphasia and its relation to functional improvement. Methods: The study was performed in 252 patients admitted for rehabilitation follow-up of their first stroke (126 patients with aphasia and hemiparesis [aphasia group] and 126 patients with hemiparesis but without aphasia [control group]). All patients were submitted to clinical, neurological, and neuropsychological examinations. The following tests were performed: Aachen Aphasia Test, Albert’s test, anosognosia scale, Cumulative Illness Rating Scale (CIRS), Fugl-Meyer Scale, and FIM^™. Results: LOS was 50.7 and 46.7 days in the aphasia and control groups, respectively. There was no statistically significant difference in the LOS between aphasia and control groups (p = .056). A longer LOS was correlated with low admission aphasia score (r = −0.19). The increase in motor FIM^™ per day obtained by therapy (LOS-Eff) was 0.54 ± 0.3 in the aphasia group and 0.75 ± 0.5 in the control group. The LOS-Eff was significantly poorer in the aphasia group (p = .000). A high LOS-Eff was correlated with high aphasia score (r = 0.31). In multivariate regression analyses, aphasia was an important predictor of LOS-Eff (β = 0.18). Conclusions: In patients with aphasia, LOS is few days longer and LOS-Eff is significantly poorer compared to patients without aphasia. Aphasia is a significant independent predictor of LOS-Eff at discharge.

Keywords:

• aphasia
• assessment
• outcome
• rehabilitation length of stay
• stroke