Low ejection fraction - Effect on the rehabilitation progress and outcome of stroke patients

Objective: To determine the effect of low ejection fraction (<= 35%) on the rehabilitation progress and outcome of stroke patients and compare these variables with patients with high ejection fraction (> 35%). Design: 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. Results: 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. Conclusion: Compared with patients in the high ejection fraction cohort, the low ejection fraction subjects had lower discharge AM 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.