Journal
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
Volume 26, Issue 12, Pages 2755-2762Publisher
ELSEVIER
DOI: 10.1016/j.jstrokecerebrovasdis.2017.06.047
Keywords
Stroke; rehabilitation; mortality; hip fracture; pneumonia
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Background: Rehabilitation is essential for all poststroke patients to improve self-care ability. However, whether an increased frequency of rehabilitation reduces poststroke adverse events remains undetermined. Methods: We recruited 4899 patients with newly diagnosed ischemic stroke between January 1, 2000, and December 31, 2008, from our database and divided them into 3 groups according to their Charlson Comorbidity Index, and they were further categorized into 3 groups of different rehabilitation frequencies during their first year after stroke. Clinical adverse events including recurrent stroke, hip fracture, pneumonia, and all-cause mortality were analyzed by Cox regression analysis to investigate the protective effects of aggressive rehabilitation. Results: We discovered that aggressive rehabilitation in the first year after stroke was significantly associated with a lower incidence of recurrent stroke and all-cause mortality despite the severity of patients' comorbidities. Further Cox regression analysis revealed decreased hazard ratios to develop recurrent stroke and all-cause mortality in patients with more intensive rehabilitation (P for trend <.05). However, no significant associations between rehabilitation frequency and pneumonia and hip fracture were identified in our study. Conclusion: Intensive rehabilitation during the first year after stroke should be recommended to prevent detrimental adverse events for stroke survivors.
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