Stroke, Vol 18, 830-836, Copyright © 1987 by American Heart Association
ML Dombovy, JR Basford, JP Whisnant and EJ Bergstralh
Medical records of all residents of Rochester, Minnesota, who had a first
stroke in 1975-1979 were reviewed to determine level of disability,
disposition, and use of rehabilitation services. Of the 292 persons with a
first stroke, 251 (86%) (mean age 70 years) survived greater than 1 week.
The mean Rankin disability score (Grade 1, no disability, through Grade 5,
severe disability) changed from 1.7 before stroke to 2.8 in survivors at
hospital discharge; 29% of those discharged required further institutional
care. The level of disability in survivors remained relatively constant
from 6 months after stroke through 5 years of observation. Of the 112
patients with an admission score of 5, 40 (36%) were alive at 1 year and
only 5 of those (13%) improved to relative independence (Rankin scores of 1
or 2). The most common comorbidity contributing to disability was
cardiovascular disease (31%). After the first 18 months, the mortality in
patients with stroke was similar to that in a normal population having the
same age and sex distribution. Of the 251 1-week survivors, 132 (53%) had
rehabilitation (physiatrist) evaluations, 127 (51%) received physical
therapy, 103 (41%) received occupational therapy, and 33 (13%) received
speech therapy. Thirty-four of the 132 patients (26%) referred for
rehabilitation evaluations were transferred to the rehabilitation unit.
ARTICLES
Disability and use of rehabilitation services following stroke in Rochester, Minnesota, 1975-1979
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