Rehabilitation outcomes of stroke patients with low left ventricular ejection fraction in the subacute rehabilitation phase
Masahiro Tsujikawa, Yohei Otaka, Rei Hasegawa, Kunitsugu Kondo, Kaori Muraoka, Meigen Liu
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
Objective: To examine the left ventricular ejection fraction in patients with subacute stroke and compare rehabilitation outcomes between those with decreased left ventricular ejection fraction and those without.
Design: Retrospective chart review.
Subjects: A total of 482 consecutive patients with stroke admitted to a convalescent rehabilitation hospital.
Methods: Patients were assessed using transthoracic echocardiography within 7 days of admission. The patients were divided into a group with low left ventricular ejection fraction and a group with preserved left ventricular ejection fraction. Functional Independence Measure (FIM) scores at admission and discharge, FIM gain, FIM efficiency, and discharge disposition were compared between groups.
Results: The low left ventricular ejection fraction group had significantly lower cognitive and total FIM scores on admission than the preserved left ventricular ejection fraction group. The patients in the low left ventricular ejection fraction group tended to be transferred to acute hospitals more frequently. How-ever, the total score of discharge FIM, FIM gain, and FIM efficiency did not differ significantly between the groups when rehabilitation was continued until discharge.
Conclusion: Stroke patients with low left ventricular ejection fraction in the subacute phase could achieve almost the same functional outcomes as those of patients with preserved left ventricular ejection fraction. Although the general medical condition should be considered, the finding of low left ventricular ejection fraction did not pose a barrier to successful rehabilitation after stroke.
Cardiac problems could be inhibitory factors during the course of rehabilitation in patients with stroke. We evaluated the influence of the left ventricular ejection fraction (LVEF) on activity of daily living in 482 patients with subacute stroke. The patients with a low LVEF had lower activity of daily living on admission to subacute rehabilitation units and tended to be transferred to acute hospitals more frequently than those with the preserved LVEF. However, activity of daily living on discharge and the degree of improvement from admission to discharge did not differ between the patients with low LVEF and those with preserved LVEF. The general medical condition in patients with low LVEF should be carefully considered; however, a low LVEF did not pose a barrier to successful rehabilitation after stroke.
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