Abstract TP146: Rate of Functional Improvement for Stroke Patients Plateaus During Inpatient Rehabilitation

Abstract

Introduction: Functional outcomes and length of stay (LOS) are common outcome measures in stroke patients at Inpatient Rehabilitation Facilities (IRF). Aim: To examine trends in functional outcomes among patients with hemorrhagic versus ischemic stroke in IRF. Methods: Using a prospectively collected database of stroke patients admitted in our health system of 5 IRFs in Houston, we reviewed patients with either ischemic or hemorrhagic stroke between 1/18 to 6/19. The main outcome measure was the FIM scores. The relationship between LOS and FIM score improvement were analyzed using a third order polynomial regression model. Results: Among 88 patients, 43% were female and 60% had an ischemic stroke. The median LOS was 21 days (IQR14, 26) for all patients; 22 (IQR16, 30) in patients with hemorrhagic stroke; 20.5 (IQR14, 25) in patients with ischemic stroke (P: 0.24). Based on change in FIM, stroke patients benefited the most from IRF in the first 17 days (P<.0001) while the improvement rate declined significantly afterwards with the highest FIM score change of 32. The FIM score changes were not significantly different when adjusting for CMI. There were no significant differences in FIM changes and extent of temporal benefit between ischemic and hemorrhagic strokes. Moreover, bathing, dressing, tub transfer and walking were the areas of greatest improvement (Median change: 2 for all variables). Conclusion: Stroke patients in our IRF network benefit the most on FIM in the first 17 days. Further studies are needed to identify factors that could maximize functional gains in IRF.