ISCHEMIC STROKE - RELATION OF AGE, LESION LOCATION, AND INITIAL NEUROLOGIC DEFICIT TO FUNCTIONAL OUTCOME

Objective: Establish the relation between age, gender, initial neurolo gic deficit, stroke location, prior stroke, hemisphere of stroke, and functional outcome in ischemic stroke. Design: Single group, multivari ate, repeated measures design with 327 persons having ischemic stroke recruited from 20 participating centers. Setting: Twenty European stro ke centers. Patients: Consecutive admissions of men and women between the ages of 40 and 85yrs with a hemispheric stroke caused by middle ce rebral artery ischemia and a Unified Neurological Stroke Scale score o f 5 to 24. Interventions: Inpatients enrolled in the trial received tr aditional rehabilitation therapies including physical therapy, occupat ional therapy, and speech therapy when appropriate. Main Outcome Measu res: Barthel Index computed at 7 to 10 days and 3 months poststroke. R esults: Positive functional outcomes were significantly related to the absence of prior strokes, a younger age, a less severe initial neurol ogic deficit, stroke involving cortical structures, and dominant (left hemisphere) lesions. Conclusions: Despite some inconsistencies in exi sting literature, standardized prospective examination of outcome afte r stroke clearly demonstrated the effect of age, initial severity of s troke, and lesion location as predictors of functional outcome. (C) 19 98 by the American Congress of Rehabilitation Medicine and the America n Academy of Physical Medicine and Rehabilitation.