Rehabilitation outcomes of stroke patients with and without diabetes

Abstract

Objective: To investigate the relation of diabetes comorbidity and the rehabilitation outcomes of patients with stroke.

Design: Secondary data analysis.

Setting: Inpatient rehabilitation facilities.

Participants: Patients with stroke (N=35,243) who received inpatient rehabilitation in 2004 through 2008.

Interventions: None.

Main outcome measures: FIM, length of stay, and discharge destination.

Results: Mean age ± SD of the sample was 71.0 ± 13.2 years. The percent of the sample of Medicare beneficiaries was 53.8%, whereas 46.2% had other sources of funding. Of the patients in the sample, 34.5% had a comorbidity of diabetes, with 17.2% classified as tier-eligible and 82.8% as nontier eligible. Findings included that patients in this sample with diabetes were admitted for rehabilitation services at a younger age than those without diabetes and support previous studies in which tier-eligible diabetes comorbidities moderated by patient age were found to be significant predictors of stroke rehabilitation outcomes. Furthermore, similar findings remained regardless of payer source.

Conclusions: This study provides additional evidence that diabetes as a comorbidity is significantly related to stroke rehabilitation outcome, but the relation is moderated by patient age.

Keywords: CI; CVA; Diabetes mellitus; ICD-9; International Classification of Diseases, 9th Revision; OR; PPS; Rehabilitation; Stroke; cerebrovascular accident; confidence interval; odds ratio; prospective payment system.