Predicting outcome after stroke: the role of aphasia

Methods. The study was carried out in 262 patients with primary diagnosis of CVA and aphasia, included over a 6-year period (2001-2007): 131 with and 131 without aphasia. Statistically significant variables at the univariate regression analysis were submitted to the multivariate analysis. Backward stepwise regression analysis was applied to predict final motor-Functional Independence Measure (FIM), effectiveness in motor-FIM, final cognitive-FIM score and effectiveness in cognitive-FIM and discharge destination. Independent variables were age, gender, aphasia, stroke type, stroke lesion size, comorbidity, bladder catheter, motor function, trunk control test, initial motor-FIM and committed caregiver identified on admission to rehabilitation. Results. Patients with aphasia had lower motor-FIM and cognitive-FIM scores both at admission and at discharge, if compared with those without aphasia. Effectiveness in motor-FIM and cognitive-FIM scores was also poorer in patients with aphasia. Seventy-seven per cent of patients with aphasia and 91.6% of patients without aphasia returned at home. In the multivariate regression analysis, aphasia was predictor of final motor-FIM (beta = 0.15), final cognitive FIM (beta = 0.72), effectiveness in motor-FIM (beta = 0.17) and discharge destination (beta = 0.20). Conclusions. Aphasia is a predicting factor of outcome and it is the most important predictor of social outcome in patients with stroke with aphasia.