Factors influencing functional recovery in patients with acute ischemic stroke

Summary Aim This study examined factors influencing functional recovery, including neurological and psychological function and activity of daily living (ADL), in individuals hospitalized with acute ischemic stroke. Methods A prospective observational study was undertaken in a sample of 141 hospitalized adults with acute ischemic stroke in three hospitals in metropolitan Bangkok and one in regional Thailand. Sociodemographic and clinical data were collected using a standardized questionnaire. Co-morbidity burden was assessed using the Charlson Co-morbidity Index-Modified-Thai version (CCI-T) and acute stroke care services usage using the Measurement of Acute Stroke Care Services Received form. Recovery of neurological function was measured by the National Institutes of Health Stroke Scale-Thai (NIHSS-T), and ADL function was measured by the Modified Barthel Index Measurement-Thai Version (BI-T). Psychological function was assessed using the Center for Epidemiologic Studies Depression Scale-Thai version (CES-D-T). Multivariate logistic regression was used to analyze the predictive ability of pre-specified variables. Results Receiving thrombolytic therapy was a significant predictor of functional recovery in terms of neurological (OR=4.714; P =.004) and ADL functions on the day of discharge (OR=5.408; P =.002). Accessing acute stroke care service was the only factor predicting improved psychological function on hospital discharge (OR=1.312; P =.049). Conclusion The best predictor for physical functional recovery was receiving thrombolytic therapy. In addition, acute stroke care services demonstrated to have an association with psychological function.