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Increasing early ambulation disability in spontaneous intracerebral hemorrhage survivors

Béjot, Yannick et al.

Neurology. Volume 90:Number 23 (2018) -- Lippincott Williams & Wilkins

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  • Title:
    Increasing early ambulation disability in spontaneous intracerebral hemorrhage survivors
  • Author: Béjot, Yannick;
    Blanc, Christelle;
    Delpont, Benoit;
    Thouant, Pierre;
    Chazalon, Cécile;
    Daumas, Anaïs;
    Osseby, Guy-Victor;
    Hervieu-Bègue, Marie;
    Ricolfi, Frédéric;
    Giroud, Maurice;
    Cordonnier, Charlotte
  • Found In: Neurology. Volume 90:Number 23 (2018)
  • Journal Title: Neurology
  • Subjects: Neurologie--Périodiques; Neurology--Periodicals; Dewey: 616.8
  • Rights: legaldeposit
  • Publication Details: Lippincott Williams & Wilkins
  • Abstract: Abstract : Objective:

    To evaluate temporal trends in early ambulatory status in patients with spontaneous intracerebral hemorrhage (ICH).

    Methods:

    All patients with ICH between 1985 and 2011 were prospectively registered in a population-based registry in Dijon, France, and included in the study. Outcomes of ICH survivors were assessed at discharge from their stay in an acute care ward with the use of a 4-grade ambulation scale. Time trends in ambulation disability and place of discharge were analyzed in 3 periods (1985–1993, 1994–2002, and 2003–2011). Multivariable ordinal and logistic regression models were applied.

    Results:

    Five hundred thirty-one patients with ICH were registered, of whom 200 (37.7%) died in the acute care ward. While the proportion of deaths decreased over time, that of patients with ambulation disability increased (odds ratio [OR] 1.67, 95% confidence interval [CI] 0.87–3.23, p = 0.124 for 1994–2002; and OR 1.97, 95% CI, 1.08–3.60, p = 0.027 for 2003–2011 vs 1985–1993 in ordinal logistic regression). The proportion of patients dependent in walking rose (OR 2.11, 95% CI 1.16–3.82, p = 0.014 for 1994–2002; and OR 2.73; 95% CI 1.54–4.84, p = 0.001 for 2003–2011), and the proportion of patients discharged to home decreased (OR 0.49, 95% CI 0.24–0.99, p = 0.048 for 1994–2002; and OR 0.32, 95% CI 0.16–0.64, p = 0.001 for 2003–2011).

    Conclusion:

    The decrease in in-hospital mortality of patients with ICH translated into a rising proportion of patients with ambulation disability at discharge. A lower proportion of patients returned home. These results have major implications for the organization of postacute ICH care.


  • Identifier: System Number: LDEAvdc_100084100692.0x000001; Journal ISSN: 0028-3878; 10.1212/WNL.0000000000005633
  • Publication Date: 2018
  • Physical Description: Electronic
  • Shelfmark(s): ELD Digital store

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