Functional Outcome after Inpatient Rehabilitation following Aneurysmal Subarachnoid Hemorrhage: A Prospective Analysis

Abstract

Subarachnoid hemorrhage (SAH) secondary to ruptured aneurysm or arteriovenous malformation is a significant cause of morbidity and mortality in adults. Neurosurgical outcomes after SAH have been extensively studied. However, functional outcomes following SAH are less well understood. Forty-one consecutive patients were admitted for rehabilitation of SAH due to aneurysm or arteriovenous malformation rupture. Age- and gender-matched groups of patients admitted for rehabilitation of stroke and traumatic brain injury (TBI) were recruited for comparison. Data were prospectively collected and analyzed. Dependent variables included lengths of stay in acute care, lengths of stay in rehabilitation, Functional Independence Measure (FIM) total and subscale score changes (admission to discharge from rehabilitation), FIM total and subscale efficiencies (FIM change per week), and dispositions (home versus not home). The average length of stay for SAH patients in acute care services was 28.7 days, and the average length of stay on the rehabilitation unit was 36.6 days. FIM improvement total was 33.7 with a FIM efficiency of 8.9 per week. No statistically significant difference in the acute lengths of stay (LOS) was noted among the three groups. A statistical trend (p < 60.06) toward longer rehabilitation LOS was observed in SAH patients (36.6 days) when compared with TBI (27.2 days) and stroke (28.9 days) patients. Overall improvement among the three groups was similar from admission to discharge in total FIM scores, each of the FIM subscales, and total and subscale FIM changes per week.