Functional outcomes of rehabilitation in patients with subacute stroke on haemodialysis
Goro Shinjo, Yohei Otaka, Kaori Muraoka, Hiroki Ebata, Meigen Liu
Department of Rehabilitation Medicine, Saiseikai Kanagawaken Hospital, Japan
Objective: To examine functional outcomes in patients with subacute stroke who are on haemodialysis.
Design: Observational cohort study.
Subjects: Patients with stroke who were admitted to rehabilitation wards between April 2011 and August 2016 were retrospectively enrolled.
Methods: Data on the Functional Independence Measure (FIM) and discharge destination were collected from medical records as outcomes. Outcomes were compared for patients who received haemodialysis and those who did not. Multiple regression analyses were carried out to explore the impact of haemodialysis on functional outcomes.
Results: Among 859 patients, 34 (mean age 63. 6 years (standard deviation (SD) 11. 7)) required haemodialysis while staying in rehabilitation wards. One hundred patients not receiving haemodialysis (mean age 70. 7 years (SD 13. 8) ) were randomly selected as controls. The total FIM score at discharge, FIM gain, FIM efficiency, FIM effectiveness, and discharge destination were not significantly different between the 2 groups (p > 0. 05). Multiple regression analysis, adjusted for other confounding factors, found no significant difference in total FIM score between groups at discharge (p = 0. 427).
Conclusion: Dialysis was not an inhibitory factor affecting outcomes during subacute rehabilitation in patients with stroke. Rehabilitation should be considered for patients with subacute stroke requiring haemodialysis, in order to provide every opportunity to achieve adequate functional outcomes.
The aim of this study was to clarify whether patients with subacute stroke who are receiving haemodialysis can attain similar functional outcomes after rehabilitation as those not receiving haemodialysis. Stroke patients who were admitted to rehabilitation wards were retrospectively enrolled. Functional outcomes were compared between 34 patients receiving haemodialysis and 100 randomly selected patients not receiving haemodialysis. The results indicate that the functional outcomes were not significantly different between the groups. Furthermore, dialysis was proven to not be an inhibitory factor that affects outcomes after controlling for possible cofounding factors. This study suggests that clinicians should consider rehabilitation for all patients with subacute stroke who require haemodialysis, in order to provide the opportunity for these patients to achieve adequate functional outcomes.
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