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Functional outcome after stroke in patients with rheumatoid arthritis and systemic lupus erythematosus†
Article first published online: 24 JUN 2008
Copyright © 2008 by the American College of Rheumatology
Arthritis Care & Research
Volume 59, Issue 7, pages 984–988, 15 July 2008
How to Cite
Nguyen-Oghalai, T. U., Wu, H., McNearney, T. A., Granger, C. V. and Ottenbacher, K. J. (2008), Functional outcome after stroke in patients with rheumatoid arthritis and systemic lupus erythematosus. Arthritis & Rheumatism, 59: 984–988. doi: 10.1002/art.23816
- Issue published online: 24 JUN 2008
- Article first published online: 24 JUN 2008
- Manuscript Accepted: 18 JAN 2008
- Manuscript Received: 20 AUG 2007
- Research Career Development award from the National Institute of Allergy and Infectious Diseases. Grant Number: BIRCWH grant K12-HD052023
- National Institute of Child Health and Human Development
- Office of the Director, NIH
- Agency for Healthcare Research and Quality, Health Services Research in Under-Served Populations. Grant Number: R24-HS011618
- T. Franklin Williams Scholars program (funded by Atlantic Philanthropies, the John A. Hartford Foundation, the American College of Rheumatology, and American Subspecialty Professor)
- National Institute on Aging, NIH. Grant Number: K02-AG019736
To compare outcomes following stroke rehabilitation among patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) versus patients with neither RA nor SLE (non-RA/SLE).
We conducted a retrospective analysis using a national database of patients with stroke admitted to inpatient rehabilitation between 1994 and 2001. Primary outcomes were discharge disposition and functional status, rated by the Functional Independence Measure (FIM) Instrument, at discharge and at followup. The independent variable was RA or SLE. Covariates were age, sex, race/ethnicity, admission FIM ratings, additional comorbidities (none, 1–3, and >3), type of stroke, and length of stay.
We studied 47,853 patients with stroke, 368 with RA, and 119 with SLE. Discharge dispositions were similar for patients with RA and non-RA/SLE (81% discharged home). At discharge, the average FIM rating for patients with RA was 85.8, compared with 87.8 for non-RA/SLE patients. At followup, the average FIM rating for patients with RA was 95.9, compared with 99.6 for non-RA/SLE patients. RA was associated with lower FIM ratings at discharge and followup in multivariate analyses. SLE was associated with younger age (17.5 years). However, patients with SLE had similar discharge dispositions and FIM ratings to non-RA/SLE patients.
RA was associated with lower functional status ratings at discharge and followup. Outpatient therapy for patients with RA may reduce long-term assistance. Patients with SLE were younger, but had similar functional outcomes to patients without RA/SLE, suggesting early morbidity from stroke among patients with SLE.