| 소속 |
Konkuk University Medical Center, Department of Rehabilitation Medicine1, Samsung Medical Center, Department of Physical and Rehabilitation Medicine2, Konkuk University, Center for Neuroscience Research, Institute of Biomedical Science & Technology3, KonKuk University School of Medicine, Research Institute of Medical Science4 |
Introduction: It is generally known that after the stroke, early rapid neurological recovery slows down during chronic poststroke period. In some patients, however, a prominent recovery pattern is observed in the chronic phase after stroke. The purpose of this study was to investigate the clinical characteristics of the patients with delayed poststroke recovery compared with patients with early neurological recovery.
Methods: In the present study, we used Korean Stroke Cohort for functioning and rehabilitation (KOSCO) data. KOSCO is a large, multi-centre, prospective cohort study for all acute first-ever stroke patients admitted to the participating hospitals in nine distinct areas of Korea. We excluded patients whose Fugl-Meyer Assessment (FMA) of upper extremity decreased by more than 3 points, whose FMA of lower extremity decreased by more than 2 points, and whose total score of FMA decreased by more than 5 points to exclude patients with poststroke neurologic deterioration. In the present study, the patient with delayed recovery was defined as one with change of FMA score (total, upper limb, and lower limb, respectively) from poststroke 3 months to 12 months over 13, 8, 5 points, and that from onset of stroke onset to 3 months.
Results: We enrolled 722 first-ever stroke patients (430 men; 62.97 ± 12.93 [20 - 98] years). Of the enrolled patients, 137 (18.98%) had delayed recovery. The initial score of FMA in patients with poststroke delayed recovery was significantly lower than that of patients with early recovery (35.28 ± 26.31 [0 - 89] vs 43.62 ± 27.46 [0 - 90], p < 0.001). In addition, patients with delayed recovery had more risk factors for stroke than patients with early recovery, with statistical significance (2.28 ± 1.24 [0 - 6] vs 2.02 ± 1.19 [0 - 7], p = 0.020). There were significant differences in the number of complications and the incidence of pneumonia during hospitalization for poststroke care and rehabilitation (8.11% vs 3.19%, p = 0.014).
Conclusion: In the present study, we found out that the incidence of poststroke complications including pneumonia and the number of risk factors for stroke were higher in patients with poststroke delayed recovery than them with early recovery. |
