Prediction of long-term functional outcome following different rehabilitation pathways after stroke unit discharge

Abstract

Objective: To investigate whether referral for different types of rehabilitation on discharge from Swedish stroke units can predict functional outcomes at 1 and 5 years after a stroke. Design: A longitudinal and registry-based study. Subjects/patients: A total of 5,118 participants with index stroke in 2011 were followed-up at 1 and 5 years after the stroke. Methods: Ordinal logistic regression models were developed to predict the category of functional outcome: independent, dependent, or dead. The primary predictors were planned rehabilitation in a home setting, inpatient rehabilitation, and outpatient rehabilitation, with no planned rehabilitation as the reference category. Results: Planned outpatient rehabilitation predicted independence (compared with death) at 1 year. Planned rehabilitation in the home setting predicted independence (compared with death) at 1 and 5 years. Compared with other planned pathways, participants planned for inpatient rehabilitation had more severe conditions, and planned inpatient rehabilitation did not predict independence. Conclusion: Planning for outpatient or home-based rehabilitation appeared to lead more effectively to participants achieving independence over the course of 1–5 years. This may have been due to the less severe nature of these participants’ conditions, compared with those requiring inpatient rehabilitation.