Typology evolution of patients hospitalized after recent stroke in PRM department over 15 years: A retrospective observational study.

OBJECTIVE: Since 10 years, health care for stroke patients had increased considerably: increasing number of the stroke units, development of authorized neurological specialized PRM departments, and new therapies used (thrombolysis, thrombectomy). These evolutions could impact the typology of patients hospitalized in PRM units after recent stroke. This study aims to look at such a possible evolution in our department, and try to identify the potential factors of change.

MATERIAL/PATIENTS AND METHODS: Retrospective study conducted on 7 years chosen over the last 15 years among hospitalized patients after recent stroke: demographic data, stroke's characteristics, treatments, length of stay and clinical characteristics. Statistic analysis on the evolution of these data was based on Chi(2) and Anova analysis.

RESULTS: Six hundred and forty-two medical records were reviewed (225 women and 417 men, 432 ischemic stroke and 210 hemorrhagic, mean age 58 years [17-93, SD 13.2])). There was no difference regarding the characteristics of stroke (ischemic/hemorrhagic, unique/multiple, first/recurrence), entrance delay and length of stay. As expected the frequency of thrombolysis and thrombectomy increased (P<0.005). The number of category 3 SOFMER patients and cognitive disorders increased (P<0.005), contrasting with the increase of walking patients at entrance and discharge, as well as the functionality of the paretic upper limb (P<0.005) which probably explain the increase of entrance (P=0.003) and discharges FIM scores (P=0.009). A significant decreasing of usual complications as disabling spasticity and shoulder pain was observed (P<0.05).

DISCUSSION - CONCLUSION: The findings showed significant changes in the typology of patients admitted after recent stroke in PRM department since 7 years, reflecting impact of health care for stroke patients.