Session Information
Date: Thursday, November 14, 2019
Session Title: Neurological Rehabilitation Research Report
Session Time: 12:30pm-2:00pm
Location: Research Hub - Kiosk 6
Disclosures: Lynne F Turner-Stokes, DM FRCP MBE: No disclosure data submitted.
Objective: To evaluate functional gain and cost-efficiency of specialist inpatient rehabilitation in patients with severe stroke admitted more than 3 months after stroke, in the context of real life clinical practice.
Design: Analysis of prospectively collected clinical data from the UKROC national clinical database.
Setting: A specialist (Levels 1 and 2) rehabilitation centres in England (n=76).
Participants: All registered patients admitted 90 days or more post-stroke between 2012-2017 (n=2174).
Interventions: In-patient rehabilitation
Main Outcome Measures: Recorded on admission and discharge, the UK FIM+FAM measures change in motor and cognitive function. The Northwick Park Dependency and Care Needs Assessment (NPDS/NPCNA) calculates cost efficiency as the time for savings in ongoing care-costs in the community to offset the initial costs of rehabilitation. Data were analysed in three groups of dependency based on NPDS scores on admission: ‘High’ (NPDS>25); ‘Medium’ (NPDS=10-25); Low (NPDS<10).
Results: Demographics: 58% Males, mean age 55.2 years (95%CI 54.6,55.8), mean length of stay 112(109,115) days. Stroke aetiology: infarct (35%), haemorrhagic (36%), sub-arachnoid haemorrhage (19%). Left/ right hemisphere stokes were equally represented. The mean (95%CI) time since onset of stroke was 403 (365, 450) days; median 140 (IQR 108-232) days. Median total UK FIM+FAM score 86 (IQR 57-125): median change from admission to discharge 24 (IQR 9-42). Mean episode cost £38,546 (£36,333, 40,894); mean reduction in care costs/week £334 (£250, £376) or £16,328 per annum. The cost of rehabilitation was offset in 28 months. Analysed by dependency group, the time to offset the costs of rehabilitation was shortest in the high-dependency group (27 months) compared with the medium (46 months) and low groups (101 months).
Conclusions: This analysis of real-life data collected in routine clinical practice demonstrates that some patients continue to make functional gains from specialist in-patient rehabilitation even more than 1year after stroke. Moreover, this intervention was highly cost-efficient, especially for the most dependent patients.
Level of Evidence: Level II
To cite this abstract in AMA style:
Turner-Stokes LF, Cardona A, Alfonso E. Benefits of In-patient Rehabilitation Late After Stroke: A Multi-centre Analysis Real-life Clinical Data from the UK Rehabilitation Outcomes Collaborative (UKROC) Database [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/benefits-of-in-patient-rehabilitation-late-after-stroke-a-multi-centre-analysis-real-life-clinical-data-from-the-uk-rehabilitation-outcomes-collaborative-ukroc-database/. Accessed May 14, 2025.« Back to AAPM&R Annual Assembly 2019
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/benefits-of-in-patient-rehabilitation-late-after-stroke-a-multi-centre-analysis-real-life-clinical-data-from-the-uk-rehabilitation-outcomes-collaborative-ukroc-database/