Factors influencing functional recovery in patients with acute ischemic stroke

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.