The Impact of Previous Strokes on the Rehabilitation of Elderly Patients Sustaining a Hip Fracture

Mizrahi EH, Fleissig Y, Arad M, Adunsky A. The impact of previous strokes on the rehabilitation of elderly patients sustaining a hip fracture. Objective: To evaluate whether a previous stroke may affect the functional outcome gain of elderly patients undergoing rehabilitation for a hip fracture. Design: A retrospective cohort study. Setting: The division of geriatric medicine with rehabilitation wards at a university-affiliated referral hospital. Participants: Patients with hip fractures (N=460) undergoing a standard rehabilitation course. Interventions: Not applicable. Main Outcome Measures: The functional outcome of previous stroke- and nonprevious stroke (NPS)-affected patients assessed by the FIM instrument at admission and discharge from the rehabilitation facility. Data were analyzed by t tests, Pearson correlation, chi-square tests, and linear regression analysis. Results: Both admission and discharge total FIM scores were significantly higher in NPS compared with previous stroke patients (63.53±19.89 vs 52.19±19.37, P<.001) and (84.23±24.93 vs 71.37±25.03, P=.001), respectively. However, changes in total FIM (20.70±11.68 vs 19.17±13.32, P=.38) and in motor FIM (19.84±10.63 vs 17.96±11.21, P=.23) at discharge were not statistically significant between the 2 groups. A linear regression analysis showed that a previous stroke was not predictive of a worse total FIM gain at discharge (P=.58). Conclusions: NPS hip fracture elderly patients show higher admission and discharge FIM scores compared with previous stroke patients. Nevertheless, both groups achieve similar FIM gains during rehabilitation period. A previous stroke should not be considered as adversely affecting the rehabilitation of such patients.