We studied 47,853 patients receiving inpatient rehabilitation services after a stroke between 1994 and 2001. The mean and median ages upon admission were 69.8 years and 72 years, respectively. The average FIM Instrument rating at admission was 63.2, and the average FIM Instrument rating at discharge was 87.7. The average FIM Instrument ratings were 93.5 for patients who were discharged home and 65.0 for patients who were not discharged home.
Patients with RA were older, more likely to be female, and more likely to be white (). On admission to inpatient rehabilitation, patients with RA had FIM Instrument ratings similar to non-RA/SLE patients. At discharge, patients with RA had average FIM Instrument ratings of 85.8, compared with 87.8 in non-RA/SLE patients. The average discharged FIM Instrument ratings were not statistically different for patients with RA versus non-RA/SLE patients (, model 1). However, after adjusting for FIM Instrument rating at admission, RA was associated with lower FIM Instrument ratings at discharge (−2.0) compared with non-RA/SLE patients (, model 2). When multivariate analyses were performed to adjust for additional covariates (age [continuous variable], sex, race/ethnicity, type of stroke, other comorbidities, and length of hospital stay), RA was still associated with lower FIM Instrument ratings (, model 3).
Baseline characteristics and outcomes of subgroups of patients with RA or SLE compared with non-RA/SLE controls*
Bivariate and multivariate analyses for FIM Instrument ratings at discharge among patients with RA versus patients without RA/SLE*
When we examined discharge dispositions, patients with RA were discharged home at similar rates to non-RA/SLE patients (81% in both groups). Logistic regression confirmed no association between RA and discharge disposition. At followup, patients with RA continued to have lower FIM Instrument ratings, averaging 95.9 as compared with 99.6 for non-RA/SLE patients ().
Graph of average FIM Instrument rating versus age group.
Among patients with stroke, 119 had SLE. Baseline characteristics of patients in the study are shown in . Patients with SLE were younger. The difference in average ages between patients with SLE and non-RA/SLE was 17.5 years. Patients with SLE were also more likely to be female. Bivariate analysis showed that patients with SLE did not have lower FIM Instrument ratings at admission than non-RA/SLE patients.
presents the FIM ratings of 5 age groups (16–44 years, 45–54 years, 55–64 years, 65–74 years, and 75–87 years), stratified by SLE, RA, and non-RA/SLE. On admission, the average FIM Instrument ratings for SLE patients in the youngest (age 16–44 years) and oldest (age 64–87 years) groups were above the average ratings for non-RA/SLE patients. However, among the age 45–64 years group, the average FIM Instrument rating at admission for patients with SLE was below the average for non-RA/SLE patients.
Bivariate analyses revealed that SLE was not associated with a lower FIM Instrument rating at discharge. Regression analyses showed no association between SLE and discharge FIM Instrument rating, after adjustment for age group, sex, race, type of stroke, or number of comorbidities (data not shown). No significant interaction between age group and SLE was detected. Discharge dispositions were not different between patients with SLE and non-RA/SLE patients. At followup, patients with SLE did not have significantly lower FIM Instrument ratings compared with non-RA/SLE patients.