Association of inpatient rehabilitation with functional outcome in patients with stroke receiving mechanical thrombectomy

ABSTRACT

Introduction

Patients with ischemic strokes that have undergone mechanical thrombectomy (MT) can still have poor functional outcomes. Limited research exists on factors that impact functional outcomes in these patients who are discharged to inpatient rehabilitation. We examined patient characteristics correlated with 90-day outcomes in ischemic stroke patients having undergone MT and undergo acute rehabilitation.

Methods

This is a retrospective study of patients (≥18 years) who were consecutively admitted to inpatient rehabilitation after undergoing MT following an ischemic stroke event from 2015 through 2018. Functional outcomes at 90-days were determined by the modified Rankin Score (mRS). Binary logistic regression models were used to measure the association of meaningful Functional Independence Measure (FIM) change with poor-outcome (mRS >2).

Results

Out of 56 stroke patients undergoing MT, 36 had poor outcome (mRS >2) at 90-days. One unit increase in discharge FIM significantly decreased the likelihood of poor outcome by 4% [aOR = 0.96; 95% CI = 95% CI = 0.92, 0.99]. Admission FIM [aOR = 0.95; 95% CI = 0.90, 1.00] and change in FIM [aOR = 0.97; 95% CI = 0.93, 1.02] were not significantly associated poor outcome in the adjusted models.

Conclusion

Patients with ischemic stroke who received MT who have a worse disability, particularly at discharge, while undergoing inpatient rehabilitation have higher odds of having poor future functional outcomes. This was regardless of age, sex, or race. Future research is needed to understand the mechanisms that can improve functional performance in our patient population at the IRF.

KEYWORDS:

• Mechanical thrombectomy
• endovascular therapy
• ischemic stroke
• acute inpatient rehabilitation
• functional outcomes

Disclosure statement

No potential conflict of interest was reported by the authors.

Disclaimer

CL is supported by the VA IK2 C×002104 and VA I21 R×003612.

Additional information

Funding

Research was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under the award number UL1TR003096.