Effects of transferring to the rehabilitation ward on long-term mortality rate of first-time stroke survivors: a population-based study

Publication date: Available online 20 April 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Chien-Min Chen, Yao-Hsu Yang, Chia-Hao Chang, Pau-Chung Chen
ObjectiveTo assess the long-term health outcomes of acute stroke survivors transferred to the rehabilitation ward.DesignLong-term mortality rates of first-time stroke survivors during hospitalization were compared among the following sets of patients: patients transferred to the rehabilitation ward (RR), patients receiving rehabilitation without being transferred to the rehabilitation ward (NtR), and patients receiving no rehabilitation (NoR).SettingWe conducted a five-year, nationwide, population-based, retrospective, cohort study, using data from the Longitudinal Health Insurance Database 2005 in Taiwan.ParticipantsA total of 11,419 patients with stroke from 2005 to 2008 were initially assessed for eligibility. After propensity score matching, 390 first-time stroke survivors were included.InterventionNone.Main Outcome MeasuresThe Cox proportional hazards regression model was used to assess differences in 5-year post-stroke mortality rates.ResultsBased on adjusted hazard ratios (HR), the NtR (adjusted HR = 2.20; 95% confidence interval (CI): 1.36–3.57) and NoR (adjusted HR = 4.00; 95% CI: 2.55–6.27) groups had significantly higher mortality risk than the RR group. Mortality rate of these stroke survivors was affected by age ≥ 65 years (compared to age < 45 years, adjusted HR = 3.62), men (adjusted HR = 1.49), ischemic stroke (adjusted HR = 1.55), stroke severity (Stroke Severity Index (SSI) ≥20, compared to SSI <10, adjusted HR = 2.68), and comorbidity (Charlson–Deyo Comorbidity Index (CCI) ≥3, compared to CCI = 0, adjusted HR = 4.23).ConclusionsFirst-time stroke survivors transferred to the rehabilitation ward had a 5-year mortality rate 2.2 times lower than those who received rehabilitation without transfer to the rehabilitation ward and 4 times lower than those who received no rehabilitation.



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