Outcome prediction in patients with putaminal hemorrhage at admission to a convalescent rehabilitation ward based on hemorrhage volume assessed with computed tomography during acute care.
Toshiki Yasukawa, Tetsuo Koyama, Yuki Uchiyama and 5 others
PMID 33519070WHAT IT FOUND
CT hemorrhage volume predicted motor independence and stay length only when age was the only other factor.
Once admission motor scores and days since onset were included, CT volume no longer predicted either outcome.
Key findings
01In models using only age and CT hemorrhage volume, both predicted discharge motor independence, and CT hemorrhage volume predicted length of stay.
02In the four-factor model, CT hemorrhage volume was not significant for discharge motor independence or length of stay.
03CT hemorrhage volume was significantly correlated with age, admission motor score, and days since onset.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The final analysis included only 52 patients from one rehabilitation ward, and the models were developed but not validated. All patients had first-ever putaminal hemorrhage, were independent before stroke, and could walk unaided, so results may not apply to more severe, surgically treated, dependent, or other stroke types. Outcomes were limited to motor independence and length of stay; swallowing, communication, cognition, and acute clinical severity were not measured. Patients received physical, occupational, and speech therapy together for up to 180 minutes daily, so the effect of any single therapy cannot be separated. Hemorrhage volume correlated with age, admission motor score, and days since onset, so its independent predictive value is uncertain.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that CT hemorrhage volume predicts functional recovery after transfer to rehabilitation. In the model that included admission motor score and days since onset, CT hemorrhage volume was not significant for discharge motor independence or length of stay.