Disposition to home or acute rehabilitation is associated with a favorable clinical outcome in the SENTIS trial. (7th April 2014)

• Record Type: Journal Article
• Authors: Belagaje, Samir R; Zander, Kay; Thackeray, Lisa; Gupta, Rishi
• Is Part Of: Journal of neurointerventional surgery. Volume 7:Number 5(2015)
• Page Start: 322
• Page End: 325
• Publication Date: 2014-04-07
• Subjects: Stroke -- Intervention; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2014-011132
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Objective: To explore the impact of stroke severity and discharge disposition on 90-day outcomes in US patients enrolled in the SENTIS trial. Methods: SENTIS is a previously published prospective randomized controlled trial. We analyzed the demographic information, National Institutes of Health Stroke Scores (NIHSS) on day 4, discharge disposition and 90-day modified Rankin Score (mRS). Univariate models were constructed to determine the impact of discharge disposition on 90-day outcomes as well as the association of the day 4 NIHSS with outcomes. Results: A total of 292 patients with a mean age of 65±14 years were analyzed. Discharge disposition was distributed as follows: 153 (52.1%) to an inpatient rehabilitation facility (IRF), 111 (38.0%) to home and 28 (9.6%) to a skilled nursing facility (SNF). Only 2 out of 28 patients (7.1%) discharged to a SNF achieved a 90-day mRS ≤2 compared with 60/153 (39.2%) in the IRF group (OR 8.39 (95% CI 1.92 to 36.64), p=0.0047). This association persisted after adjusting for age and admission NIHSS. Only 3 of 50 patients (6%) with a NIHSS of ≥14 at day 4 achieved a mRS 0–2 at day 90. Conclusions: This analysis shows that discharge to an IRF is associated with better neurological outcomes than discharge to a SNF. Additionally, patients with a NIHSS of ≥14 at day 4 are unlikely to achieve independent function.