REHABILITATION OF THE POST-CARDIAC SURGERY STROKE PATIENT - ANALYSIS OF COGNITIVE AND FUNCTIONAL ASSESSMENT

Objective: Determine whether, as expected, patients sustaining post-ca rdiac surgery stroke (PCS) (n = 19) differ from other stroke (OS) pati ents (n = 216). Design: A total of 235 stroke patients were surveyed. Therapist ratings of Functional Independence Measure (FIM) on admissio n to and discharge from a rehabilitation unit were compared. Cooperati on with formal neuropsychologic evaluation was assessed. Setting: The rehabilitation unit of a tertiary care hospital. Participants: Medical records for consecutive stroke patients were reviewed (January 1994 t o December 1995). Groups did not differ in age, gender, or admission F IM. Interventions: Standardized neuropsychologic evaluation of seven c ognitive domains was attempted for each patient referred to the neurop sychology service. All of the patients received FIM ratings on admissi on to and discharge from the rehabilitation unit. Outcome Measures: Ga in in FIM per week of rehabilitation unit stay (FIM efficiency) and di scharge destination. Results: Contrary to expectations, PCS patients d id not differ significantly from OS patients in FIM efficiency or disc harge destination. However, PCS patients were significantly less able to cooperate with formal neuropsychologic testing, possibly secondary to their physical condition, higher-level cognitive deficits, or both. Conclusion: Although PCS patients may sustain medical and cognitive d eficits that interfere with exhaustive neuropsychologic evaluation, th ese deficits do not significantly interfere with functional progress i n rehabilitation and should not make PCS patients ineligible for rehab ilitation services. (C) 1998 by the American Congress of Rehabilitatio n Medicine and the American Academy of Physical Medicine and Rehabilit ation.