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Ischemic stroke
Original research
Disposition to home or acute rehabilitation is associated with a favorable clinical outcome in the SENTIS trial
Free
  1. Samir R Belagaje1,
  2. Kay Zander2,
  3. Lisa Thackeray3,
  4. Rishi Gupta4
  1. 1Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
  2. 2CoAxia, Inc., Maple Grove, Minneapolis, Minnesota, USA
  3. 3NAMSA, Inc., Minneapolis, Minnesota, USA
  4. 4Wellstar Neurosurgery, Kennestone Hospital, Marietta, Georgia, USA
  1. Correspondence to Dr Rishi Gupta, Wellstar Neurosurgery, 61 Whitcher Street, Suite 3110, Marietta, GA 30060, USA; Rishi.gupta{at}wellstar.org

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.

  • Stroke
  • Intervention

https://doi.org/10.1136/neurintsurg-2014-011132

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