Functional outcome in stroke patients with atrial fibrillation

Objectives: To identify the prevalence of atrial fibrillation (AF) in a sam ple of stroke patients and to evaluate the impact of AF on patient clinical characteristics and functional outcome. Design: A retrospective case-comparison study. Setting: University-affiliated rehabilitation centers. Participants: One hundred ninety-six of 231 consecutive stroke patients adm itted to inpatient rehabilitation units were evaluated during the rehabilit ation period. Main Outcome Measures: Characteristics of cerebral lesions, patient demogra phic features, disease duration, length of hospital stay (LOS), risk factor s for stroke, and functional status at admission and at discharge were asse ssed and compared in patients with and without AE Functional Independence M easure(TM) (FIM) and Adapted Patient Evaluation Conference System (APECS) w ere used to evaluate functional status. Results: AF was diagnosed in 41 (20.1%) patients. Patients who had AF were more likely to have ischemic cerebral lesions. There were no significant di fferences between the AF and non-AF groups with regard to mean age, LOS, an d disease duration. Ischemic and valvular heart disease were more common in patients with AE Based on FIM and APECS scores, both initial and discharge disability were more severe in patients with AE In a multivariate model, A F was a negative prognostic factor for functional outcome in stroke patient s. Conclusion: AF is not only associated with increased risk of stroke, but al so with markedly greater disability in stroke patients. Factors such as siz e and type of cerebral lesions, stroke severity, comorbid conditions, and i mpact of AF on systemic and cerebral circulation can influence stroke recov ery.