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Sex differences in the outcomes of adults admitted to inpatient rehabilitation after stroke

MacDonald SL, Hall RE, Bell CM, Cronin S, Jaglal SB. PM R. 2021; Jun 28 [Epub ahead of print]. DOI: https://doi.org/10.1002/pmrj.12660


Introduction — Several differences between male and female patients with stroke in clinical and sociodemographic features, treatment, and outcomes have been reported. Potential effects in the inpatient rehabilitation population are unclear.

Objective — To evaluate the differences between males and females in discharge functional status, length of stay, and discharge home after inpatient rehabilitation for stroke.

Design — Retrospective, population-based cohort study.

Setting — Inpatient rehabilitation centers in Ontario, Canada.

Participants — Males (N=10,684) and females (N=9,459) discharged from acute care between September 1, 2012 and August 31, 2017 with a diagnosis of stroke and subsequently admitted to inpatient rehabilitation.

Exposure Variable — Female sex.

Main Outcome Measures — Discharge Functional Independence Measure score, length of stay, and discharge home.

Results — Females had a lower functional status at discharge (mean FIM score 94.1 vs 97.8, P<0.0001) and a lower proportion were discharged home (81.1% vs 82.9%, P=0.001). Females and males had similar rehabilitation length of stay (mean 31.8 vs 31.7 days, P=0.90). In the adjusted analyses, there was no difference in discharge functional status between males and females (FIM score β -0.20, [95% CI, -0.64 to 0.25]). Females had a mean length of stay 2% shorter (0.98 [95% CI, 0.96 - 0.99]) and a higher odds of discharge home (OR 1.14 [95% CI, 1.05-1.24]).

Conclusions — There were no clinically significant sex differences in outcomes after inpatient rehabilitation for stroke. Observed sex disparities in the general stroke population may not be directly applicable to individuals undergoing inpatient rehabilitation. This article is protected by copyright. All rights reserved.

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