Recovery from stroke: differences between subtypes

The objective of this study was to compare the differences in patterns of recovery and incidence of medical complications in hemorrhagic and ischemic stroke patients admitted for rehabilitation, using a retrospective case series design. It was set in three tertiary care facilities in London, Ontario, Canada. Eight-hundred-and-nineteen consecutive patients, admitted from 1997 to 2001 for rehabilitation following cerebrovascular event, were reviewed. The main outcome measures were: age, length of hospital stay, time to admission, medical complications, ambulation status and functional independence measure scores on both admission and discharge. The results showed that 110 patients had strokes that were hemorrhagic, while 709 were ischemic. The hemorrhagic stroke patients were younger (66 vs. 70 years, P=0.001) and were admitted later post stroke onset (30 vs. 18 days, P < 0.0001). They had a higher incidence of pneumonia (6.4 vs. 2.7%, P=0.04), pulmonary emboli (3.6 vs. 0.07%, P=0.006) and wheelchair ambulation on admission (53 vs. 41%, P=0.026). There was no significant difference in incidence of seizures or wheelchair ambulation on discharge, length of rehabilitation stay or Functional Independence Measure scores on both admission and discharge. In conclusion, hemorrhagic stroke patients took longer than ischemic stroke patients to enter into rehabilitation, and were more inclined to experience ambulatory impairments and develop medical complications.