Effect of functional status on survival in patients with stroke: Is independent ambulation a key determinant?
Journal
Archives of Physical Medicine and Rehabilitation
Journal Volume
93
Journal Issue
3
Pages
527-531
Date Issued
2012
Author(s)
Abstract
Objective: To investigate the effect of functional status, measured using the Modified Rankin Scale (MRS), at 3 months after stroke on survival in patients with stroke. Design: Cohort study. Setting: Referral medical center. Participants: Patients with stroke (N=1032). Interventions: Not applicable. Main Outcome Measure: Survival after stroke. Results: The Kaplan-Meier survival curves stratified by the 3-month MRS score showed 2 clear groups of patients with 3-month MRS scores of 0 to 3 (able to walk without assistance) and 4 or 5 (unable to walk without assistance). Accordingly, we grouped the patients into a high function (HF) group (3-month MRS?3) and a low function (LF) group (3-month MRS?4). Multiple Cox regression analysis showed that the LF group had significantly poorer survival (adjusted hazard ratio=4.69; 95% confidence interval [CI], 2.89 -7.60; P<.001) than the HF group. Other significant risk factors of higher mortality were older age, history of diabetes mellitus, and heart disease. Conclusions: This study showed a significant influence of the 3-month MRS score on stroke survival. Moreover, independent ambulation may be a major determinant of a favorable survival prognosis. This finding suggests a potential role of rehabilitation in promoting stroke survival by maximizing ambulation function. ? 2012 by the American Congress of Rehabilitation Medicine.
Other Subjects
adult; aged; article; cohort analysis; confidence interval; controlled study; diabetes mellitus; female; functional status; hazard ratio; heart disease; human; Kaplan Meier method; major clinical study; male; medical history; mobilization; mortality; prognosis; proportional hazards model; Rankin scale; risk factor; senescence; statistical significance; stroke; stroke patient; survival rate; age; comorbidity; convalescence; daily life activity; middle aged; motor activity; prospective study; psychological aspect; socioeconomics; stroke; survival; Activities of Daily Living; Adult; Age Factors; Aged; Aged, 80 and over; Comorbidity; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Motor Activity; Prognosis; Prospective Studies; Recovery of Function; Risk Factors; Socioeconomic Factors; Stroke; Survival
Type
journal article