Dependence in prestroke mobility predicts adverse outcomes among patients with acute ischemic stroke

Mary I. Dallas, Shari Rone-Adams, John L. Echternach, Lawrence M. Brass, Dawn M. Bravata

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

BACKGROUND AND PURPOSE: Stroke survivors are commonly dependent in activities of daily living; however, the relation between prestroke mobility impairment and poststroke outcomes is poorly understood. The primary objective of this study was to evaluate the association between prestroke mobility impairment and 4 poststroke outcomes. The secondary objective was to evaluate the association between prestroke mobility impairment and a plan for physical therapy. METHODS: This was a secondary analysis of the National Stroke Project data, a retrospective cohort of Medicare beneficiaries who were hospitalized with an acute ischemic stroke (1998 to 2001). Logistic-regression modeling was used to examine the adjusted association between prestroke mobility impairment with patient outcomes and a plan for physical therapy. RESULTS: Among the 67 445 patients hospitalized with an ischemic stroke, 6% were dependent in prestroke mobility. Prestroke mobility dependence was independently associated with an increased odds of poststroke mobility impairment (odds ratio [OR]≤9.9; 95% CI, 9.0 to 10.8); in-hospital mortality (OR≤2.4; 95% CI, 2.2 to 2.7); discharge to a skilled nursing facility (OR≤3.5; 95% CI, 3.2 to 3.8); and the combination of in-hospital death or discharge to a skilled nursing facility (OR≤3.5; 95% CI, 3.3 to 3.8). Prestroke mobility dependence was independently associated with a decreased odds of having a plan for physical therapy (OR≤0.79; 95% CI, 0.73 to 0.85). CONCLUSIONS: These data, obtained from a large, geographically diverse cohort from the United States, demonstrate a strong association between dependence in prestroke mobility and adverse outcomes among elderly stroke patients. Clinicians should screen patients for prestroke mobility impairment to identify patients at greatest risk for adverse events.

Original languageEnglish (US)
Pages (from-to)2298-2303
Number of pages6
JournalStroke
Volume39
Issue number8
DOIs
StatePublished - Aug 1 2008

Keywords

  • Cerebrovascular accident
  • Elderly
  • Outcome assessment
  • Walking

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Medicine(all)

Fingerprint Dive into the research topics of 'Dependence in prestroke mobility predicts adverse outcomes among patients with acute ischemic stroke'. Together they form a unique fingerprint.

Cite this