Length of stay and functional outcomes among patients with stroke discharged from an inpatient rehabilitation facility in Saudi Arabia

Abstract

Background: In many countries, the length of stay (LOS) for inpatient rehabilitation following stroke has gradually decreased. It is unclear whether this trend is associated with differences in functional outcomes, especially in developing countries. This study aimed to examine associations between LOS and functional outcomes among patients with stroke discharged from an inpatient rehabilitation facility in Saudi Arabia. Material/Methods: This retrospective study included all patients (N=409) aged ≥18 years who were admitted to an inpatient rehabilitation for stroke during 2008-2014. There were no deaths in the cohort during the study period. Patients were divided into 4 groups according to days of rehabilitation: ≤30 days (n=114), 31-60 days (n=199), 61-90 days (n=72), and >90 days (n=24). Multivariate regression analyses were used to evaluate functional outcomes using the functional independence measure (FIM). Results: The fully adjusted model showed that higher total and subscale FIM scores were significantly associated with a LOS ≤30 days (total β: 18.2, standard error [SE]=4.43, P≤0.0001; motor-FIM: β=13.9, SE=3.70, P=0.0002; cognitive- FIM: β=4.3, SE=1.29, P=0.001), and 31-60 days (total β: 11.3, SE=4.07, P=0.005; motor-FIM: β=8.8, SE=3.40, P=0.009; cognitive-FIM: β=2.4, SE=1.19, P=0.038) compared with >90 days. Conclusions: A short or intermediate LOS is not necessarily associated with worse outcomes, assuming adequate care is provided.