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Comparison between Ischemic and Hemorrhagic Strokes in Functional Outcome at Discharge from an Intensive Rehabilitation Hospital
Open accessAbstract
Comparison studies on recovery outcomes in ischemic (IS) and hemorrhagic strokes (HS) have yielded mixed results. In this retrospective observational study of consecutive IS and HS patients, we aimed at evaluating functional outcomes at discharge from an intensive rehabilitation hospital, comparing IS vs. HS, analyzing possible predictors. Modified Rankin Scale (mRS) at discharge was the main outcome. Out of the 229 patients included (mean age 72.9 ± 13.9 years, 48% males), 81 had HS (35%). Compared with IS (n = 148), HS patients were significantly younger (75 ± 12.5 vs. 68.8 ± 15.4 years, p = 0.002), required longer hospitalizations both in acute (23.9 ± 36.7 vs. 35.2 ± 29.9 days, p = 0.019) and rehabilitation hospitals (41.5 ± 31.8 vs. 77.2 ± 51.6 days, p = 0.001), and had more severe initial clinical deficit (mean number of neurological impairments: 2.0 ± 1.1 vs. 2.6 ± 1.4, p = 0.001) and mRS scores at admission (p = 0.046). At discharge, functional status change, expressed as mRS, was not significantly different between IS and HS (F = 0.01, p = 0.902), nor was the discharge destination (p = 0.428). Age and clinical severity were predictors of functional outcome in both stroke types. On admission in an intensive rehabilitation hospital, HS patients presented a worse functional and clinical status compared to IS. Despite this initial gap, the two stroke types showed an overlapped trajectory of functional recovery, with age and initial stroke severity as the main prognostic factors.
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Studies support the same or even better functional prognosis in stroke survivors with hemorrhagic stroke, with age and initial stroke severity as the main prognostic factors.
“Nevertheless, despite hemorrhagic stroke patients usually presenting with worse functional and clinical status compared to ischemic stroke, there are studies that support the same or even better functional prognosis in stroke survivors with hemorrhagic stroke, with age and initial stroke severity as the main prognostic factors [62, 63].”
From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [63]
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Paolucci, S., Antonucci, G., Grasso, M. G., Bragoni, M., Coiro, P., De Angelis, D., Fusco, F. R., Morelli, D., Venturiero, V., Troisi, E., et al. (2003) · Stroke · doi:10.1161/01.str.0000102902.39759.d3 · Cited by 283
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Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial
García-Pérez, P., Rodríguez-Martínez, M. C., Gallardo-Tur, A., Blanco-Reina, E., de la Cruz-Cosme, C., & Lara, J. P. (2024) · PLoS ONE · doi:10.1371/journal.pone.0308800 · Cited by 19
“…patients usually presenting with worse functional and clinical status compared to ischemic stroke, there are studies that support the same or even better functional prognosis in stroke survivors with hemorrhagic stroke, with age and initial stroke severity as the main prognostic factors [62, 63].”
Metadata
- Authors
- Salvadori, E., Papi, G., Insalata, G., Rinnoci, V., Donnini, I., Martini, M., Falsini, C., Hakiki, B., Romoli, A., Barbato, C., Polcaro, P., Casamorata, F., Macchi, C., Cecchi, F., & Poggesi, A.
- Affiliations
- Don Carlo Gnocchi Foundation (IT)
- University of Florence (IT)
- Corresponding author
- Poggesi, Anna
- ORCID
- Venue
- Diagnostics
- Publisher
- MDPI AG
- Published
- 2020-12-28
- Volume
- 11
- Issue
- 1
- Pages
- 38
- ISSN
- 2075-4418 (ISSN-L)
- PMC
- PMC7824133
- OpenAlex
- W3116436676
- Cited by
- 107
- References
- 1
- Citations by year
- 2026: 14 · 2025: 20 · 2024: 27 · 2023: 29 · 2022: 14 · 2021: 3
- FWCI
- 6.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diagnostics (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Florence Research (University of Florence) (submittedVersion, other-oa)
- Funders
- Fondazione Cassa di Risparmio di Firenze (Bando Ricerca Scientifica e Tecnologica 2020)
- Fondazione Don Carlo Gnocchi (Ricerca Corrente 2020)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Clinical Neurology › Intracerebral and Subarachnoid Hemorrhage Research
- Keywords
- ischemic stroke, hemorrhagic stroke, functional outcome, stroke rehabilitation, modified Rankin Scale, functional recovery, prognostic factors, age, stroke severity, discharge disposition, length of hospital stay
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