The factors associated with the deterioration of activities of daily life in stroke patients: A retrospective cohort study
Chenlan Shao, Yongzheng Wang, Hui Gou, Tingting Chen
Abstract
Background The activities of daily life (ADL) of stroke patients generally improves after rehabilitation. However, some patients remain at risk of ADL deterioration in the future. So far, there have been few studies on the factors related to ADL deterioration in stroke patients.Objective To identify the factors related to ADL deterioration in stroke patients with independent mobility after discharge.Methods We assessed 336 stroke patients with independent mobility who were discharged from the rehabilitation center between January 2016 and December 2018. The primary outcome was ADL deterioration, defined as that ADL assessed at 2 years after discharge decreased more than 15 points compared with that assessed at discharge. Univariate and multivariate statistical analyses were conducted to screen for factors related to ADL deterioration.Results Overall, 62 (18.4%) patients exhibited ADL deterioration at 2 years after discharge.Age (OR = 1.114, 95%CI = 1.045–1.188, p = 0.001), vascular risk factors>3 (OR = 3.269, 95%CI = 1.189–8.986, p = 0.022) and with post-stroke depression (OR = 2.486, 95%CI = 1.011–6.114, p = 0.047) were risk factors for ADL deterioration in stroke patients. In contrast, elevated Berg Balance Scale (BBS) scores at discharge was a protective factor for ADL deterioration (OR = 0.484, 95%CI = 0.386–0.606, p < 0.001).Conclusions Nearly 1 in 5 stroke patients with independent mobility experienced ADL deterioration at 2 years after discharge. Aging, vascular risk factors>3, BBS at discharge, and post-stroke depression (PSD) were identified as factors associated with ADL deterioration