LAUSR

Introduction: Posterior circulation strokes (PCS) are considered to have poor outcomes with high mortality and morbidity, but comparisons of functional outcome with anterior circulation strokes (ACS) have yielded conflicting results. Differences in demographics, cardiovascular risk factors and stroke etiology have been proposed, with ischemic PCS patients tending to be younger, more often male, and more frequently diabetic. Objectives: Describe the clinicodemographic profile and functional outcomes in PCS patients admitted to inpatient rehabilitation (IPR), and identify factors associated with functional change. Methods: A retrospective review of a database maintained on consecutive stroke patients admitted to IPR at Memorial Hermann-TIRR between 2017 and 2019 was conducted. Demographics, Functional Independence Measure (FIM) scores, and discharge disposition of 806 patients were assessed. Table 1 displays significance testing by univariate analysis. Baseline characteristics, pre-stroke mRS, NIHSS, admit FIM, and length of stay (LOS) in IPR were adjusted in regression models. Results and Conclusions: Results are summarized in Table 1. Diabetes and prior stroke or TIA occurred in higher percentages of patients with PCS, or concurrent ACS/PCS. NIHSS was higher in ACS patients with a mean of 9.6 (SD 7.1, p<0.001) and median of 6 with IQR of 11. Total FIM score on admission to IPR was 53.3 (SD 16.5) for PCS compared to 46.6 (SD 16.9, p<0.001) in ACS patients. Motor FIM score change was 28.6 (SD 12.2) in PCS compared to 27.2 (SD 12.8) in ACS. Adjusting for baseline variables of admit FIM, NIHSS and LOS, we found no significant differences in total or motor FIM change between the groups from admission to discharge. There was no greater odds for improvement on total or motor FIM for ACS compared to PCS. In summary, patients with PCS and ACS respond similarly to rehab therapy as captured on the FIM score, with a higher amount of therapy associated with better improvement.