Factores pronósticos en el ictus. De la fase aguda a los tres años

Abstract

Introduction Stroke is the first cause of permanent disability in adults. The greatest attention is given to the acute phase. There are very few studies focused on the subacute or chronic stages. Objective To evaluate functional status and the factors that determine improvement in stroke survivors. Patients and methods Longitudinal, observational and prospective study. All stroke patients admitted to our hospital from May to July 2004 were evaluated during the first week, at 6 months and three years. Functional improvement was evaluated by change in Barthel index and modified Rankin scale using Wilcoxon signed-rank test. The analysis of those factors related to functional change was done with contingence tables for categorical variables, t-test for quantitative variables with normal distribution and non-parametrical tests (Mann Whitney U Test) for non normal distribution. Statistical significance P < .05. Results A total of 61 patients, 64% males, were included. Average age was 72.4 years (SD 10.1). The factors that significantly affected functional improvement were: Previous Rankin, NIHSS score in acute phase, presence of impairment and undergoing a rehabilitation program. Conclusions Stroke produces a functional loss that tends to improve during the first six months and stabilizes afterwards. Previous functionality, initial NIHSS punctuation, and rehabilitation treatment are associated with better functional progress.