RESEARCH - Functional outcome after stroke in patients with RA and SLE

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Arthritis Rheum. 2008 Jun 24;59(7):984-988.

Functional outcome after stroke in patients with rheumatoid arthritis

and systemic lupus erythematosus.

Nguyen-Oghalai TU, Wu H, McNearney TA, Granger CV, Ottenbacher KJ.

University of Texas Medical Branch, Galveston.

OBJECTIVE: To compare outcomes following stroke rehabilitation among

patients with rheumatoid arthritis (RA) or systemic lupus

erythematosus (SLE) versus patients with neither RA nor SLE

(non-RA/SLE). METHODS: We conducted a retrospective analysis using a

national database of patients with stroke admitted to inpatient

rehabilitation between 1994 and 2001. Primary outcomes were discharge

disposition and functional status, rated by the Functional

Independence Measure (FIM) Instrument, at discharge and at followup.

The independent variable was RA or SLE. Covariates were age, sex,

race/ethnicity, admission FIM ratings, additional comorbidities (none,

1-3, and >3), type of stroke, and length of stay. RESULTS: We studied

47,853 patients with stroke, 368 with RA, and 119 with SLE. Discharge

dispositions were similar for patients with RA and non-RA/SLE (81%

discharged home). At discharge, the average FIM rating for patients

with RA was 85.8, compared with 87.8 for non-RA/SLE patients. At

followup, the average FIM rating for patients with RA was 95.9,

compared with 99.6 for non-RA/SLE patients. RA was associated with

lower FIM ratings at discharge and followup in multivariate analyses.

SLE was associated with younger age (17.5 years). However, patients

with SLE had similar discharge dispositions and FIM ratings to

non-RA/SLE patients.

CONCLUSION: RA was associated with lower functional status ratings at

discharge and followup. Outpatient therapy for patients with RA may

reduce long-term assistance. Patients with SLE were younger, but had

similar functional outcomes to patients without RA/SLE, suggesting

early morbidity from stroke among patients with SLE.

PMID: 18576291

http://www.ncbi.nlm.nih.gov/pubmed/18576291

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