Predictors of favorable outcome in elderly stroke patients two years afterdischarge from geriatric rehabilitation

This study was done to determine the independent predictors of long-term su rvival and long-term functional outcome in geriatric stroke patients with a high level of co-morbidity. We prospectively recruited 302 consecutive pat ients transferred from local hospitals of acute care to inpatient geriatric rehabilitation with a median of 23 days after stroke. The cohort with a me an age of 75.1 (range 60-90) years was followed up for 2 years after discha rge from rehabilitation. The 24 month survival rate was 71.2%. Urinary cont inence (p = 0,000), younger age (p = 0.000), and absence of coronary artery disease (CAD) (p = 0.039) were predictors of survival. Independence in act ivities of daily living (Barthel Index (BI) greater than or equal to 85) 24 months after discharge was 43.2% and predicted by an admission BI greater than or equal to 50 (p = 0.000), urinary continence (p = 0.007), and absenc e of CAD (p = 0.018). Good functional outcome by the Modified Rankin Scale (MRS less than or equal to 3) 24 months after discharge was 38.4%. It was p redicted by absence of CAD (p = 0.001), first-ever stroke (p = 0.014), admi ssion BI greater than or equal to 50 (p = 0.024), urinary continence (p = 0 .025), mild motor paresis (p = 0.032), and good sitting balance (p = 0.039) . Our study of a relatively aged and co-morbid stroke cohort confirmed most of the well-known predictors of outcome. A new result is that CAD also see ms to be an important determinant of long-term outcome.