The Effect of Anemia on the Functional Outcomes of the Stroke Patients and the Efficiency of their Stroke Rehabilitation

Abstract

There has been limited study focusing on the functional outcomes of stroke patients' after rehabilitation, such as functional improvement and discharge destination, length of stay (LOS), and complication rate. A retrospective study was conducted on 123 consecutive patients who were admitted to The Prince Charles Hospital Rehabilitation Unit from January 2011 to December 2012 with clinically defined stroke syndromes. Functional Independence Measure (FIM) score was used to measure the functional improvement. Anemia is defined by using the World Health Organization's criteria (hemoglobin concentration in men <120mg/dL and in women <110mg/dL). During the 2-year period, of the 123 stroke patients, 33 were found to be anemic (26.8%). The demographic factors, baseline admission FIM score, comorbidities, and the types of stroke were all comparable in both anemic and nonanemic groups. It was found that, when selecting only the patients with ischemic stroke for comparison (103 patients), there was a significantly higher FIM score improvement (discharge FIM-admission FIM) in nonanemic group (P=.042). FIM efficiency (FIM change/LOS) was also significantly higher in the nonanemic group (P=.027). Higher percentage of patients were discharged home in nonanemic group (94.3% versus 73.3%, P=.006). In addition, higher rateof complications was found in anemic group (60% versus 39%, P=.049). Anemia appears to have a significant effect on the functional improvement and discharge outcomes for patients who had an ischemic stroke. Anemia mayalso increase the complication rate and affect the efficiency of stroke rehabilitation for those patients.