Low ejection fraction: effect on the rehabilitation progress and outcome of stroke patients.

Abstract

To determine the effect of low ejection fraction (<or=35%) on the rehabilitation progress and outcome of stroke patients and compare these variables with patients with high ejection fraction (>35%). A retrospective chart review of the 332 stroke patients admitted to the inpatient rehabilitation unit of an acute tertiary general hospital during a 36-mo period. A total of 262 (79%) of these patients (126 men and 136 women) had an ejection fraction study performed and are the subjects of this analysis. They were classified into two groups: low ejection fraction (n = 36) and high ejection fraction (n = 226). The main outcome measures included discharge total FIM score, FIM gain, FIM efficiency, length of stay, and discharge disposition. Patients with low ejection fraction had lower discharge FIM scores (82.9 vs. 89.1, t = 2.09, P < 0.04), lower FIM gain (15.9 vs. 19.3, t = 1.99, P < 0.05), and lower FIM efficiency (1.2 vs. 1.7, t = 232, P < 0.03), and they were less likely to return home (69% vs. 85%, chi 2= 5.25, P < 0.04) as compared with patients with high ejection fraction. Lengths of stay were not significantly different between the two groups. Compared with patients in the high ejection fraction cohort, the low ejection fraction subjects had lower discharge FIM scores, FIM gains, and FIM efficiency. However, almost 70% progressed well enough to be discharged to home. Low ejection fraction in stroke patients may well serve as an indicator of a patient population with greater medical and social needs.