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(Stroke. 2002;33:1845.)
© 2002 American Heart Association, Inc.

Original Contributions

Stroke Rehabilitation

Indwelling Urinary Catheters, Enteral Feeding Tubes, and Tracheostomies Are Associated With Resource Use and Functional Outcomes

Elliot J. Roth, MD; Linda Lovell, BS; Richard L. Harvey, MD; Rita K. Bode, PhD Allen W. Heinemann, PhD

From the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (E.J.R., R.L.H., R.K.B., A.W.H.), and Rehabilitation Institute of Chicago (E.J.R., L.L., R.L.H., R.K.B., A.W.H.), Chicago, Ill.

Correspondence to Elliot J. Roth, MD, Rehabilitation Institute of Chicago, 345 E Superior St, Chicago, IL 60611-3015. E-mail ejr{at}northwestern.edu

Background and Purpose— The aim of this study was to investigate the associations between tracheostomies, enteral feeding tubes, and indwelling urinary catheters and functional outcome measures, incidence of medical complications, and resource use in an inpatient stroke rehabilitation program.

Methods— A cohort of 1553 patients consecutively admitted for inpatient stroke rehabilitation was studied. Demographic and stroke characteristics, impairment (National Institutes of Health Stroke Scale) and disability level (Functional Independence Measure [FIM]), preexisting medical conditions, and the presence of tracheostomies, enteral feeding tubes, and indwelling urinary catheters were recorded at admission. The occurrence of medical complications during rehabilitation, discharge disability level, length of rehabilitation stay, and rehabilitation hospital charges were recorded at discharge.

Results— Compared with patients with no medical tubes, patients with 3 medical tubes had significantly higher National Institutes of Health Stroke Scale scores, lower admission and discharge FIM scores, reduced FIM efficiency scores (average FIM score change per day), and twice the number of medical complications. Patients with 3 medical tubes stayed 28 days longer in acute hospitalization and 20 days longer in rehabilitation compared with patients with no medical tubes. The presence of even a single medical tube was associated with longer length of stay, more medical complications during rehabilitation, and greater disability level at discharge.

Conclusions— The presence of 1 medical tubes is associated with more severe and disabling strokes, an increased number of medical complications, longer acute and rehabilitation hospitalizations, and greater resource use.

Key Words: catheters, indwelling • cerebrovascular disorders • enteral nutrition • rehabilitation • stroke outcome • tracheostomy

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