Introduction:
We examined patient characteristics associated with cognitive improvement during inpatient rehabilitation.
Methods:
This was a retrospective review of clinical data from inpatient stroke rehabilitation units collected from 9/2017- 8/2019. Multiple and logistic regressions were used to examine the relationship between demographics, vascular risk factors and cognitive Functional Independence Measure (FIM) change scores on comprehension, expression, social interaction, problem solving, and memory in stroke patients, adjusted for cognitive FIM scores on admission.
Results:
The study cohort consisted of 680 patients with a mean age of 68 ± 14 years and median hospital LOS of 15 days. The percentage of patients that improved on comprehension, expression, social interaction, problem solving, and memory FIM scores was 61%, 65%, 62%, 64%, and 64%, respectively. Multiple regression analysis indicated that predictors of cognitive recovery included hypertension, stroke type, age, and NIHSS score. Specifically, hypertension predicted significantly less improvement on problem solving FIM scores (p=.033). Intracerebral hemorrhage (ICH) predicted significantly greater improvement on comprehension and problem solving FIM scores as compared to ischemic stroke (p=.047, p=.032, respectively). Compared to age < 65, age ≥ 65 predicted less improvement on comprehension, expression, and memory FIM scores (p<.001, p=.003, p<.001, respectively). NIHSS scores ≥ 21 predicted less improvement on comprehension, expression and problem solving FIM scores than NIHSS scores < 20 (p=.013, p=.017, p=.005, respectively). Logistic regression analysis suggested that the odds of cognitive improvement (defined as at least three FIM score changes ≥2) for ICH was 1.7 times greater than ischemic stroke (95% CI 1.07-2.72; Table 1).
Conclusion:
Hypertension, stroke type, age, and NIHSS score have profound impacts on cognitive recovery in during inpatient rehabilitation.
Cognitive recovery following concussion in high school athletes
