Professional paper
Stroke outcomes in Croatian and Bulgarian patients measured by modified Rankin scale
Elena ILIEVA
; Department of Physical Medicine and Rehabilitation, Medical University - Plovdiv, Bulgaria
Saša MOSLAVAC
orcid.org/0000-0002-5327-0050
; 2Special Medical Rehabilitation Hospital, Varaždinske Toplice, Croatia
Mariya GONKOVA
; Department of Physical Medicine and Rehabilitation, Medical University - Plovdiv, Bulgaria
Aleksandra MOSLAVAC
; Department of Physical Medicine and Rehabilitation, Medical University - Plovdiv, Bulgaria
Elica ANASTASSOVA
; Department of Physical Medicine and Rehabilitation, Medical University - Plovdiv, Bulgaria
Ivan DŽIDIĆ
; Department of Physical Medicine and Rehabilitation, Medical University - Plovdiv, Bulgaria
Abstract
The purpose of the study was to measure functional outcomes of stroke patients
undergoing rehabilitation in Croatia and Bulgaria using modified Rankin scale
(mRS) as a clinician-reported measure of global disability. Fewer days are allowed
for rehabilitation in Bulgaria than in Croatia according to the payers’ rules, and
the aim of the study was to assess the impact of length of stay to the progress
of patients. Data on 50 stroke patients from each of two countries were analyzed
that were matched by gender, age at stroke, days from stroke to the onset of
rehabilitation, type, side and severity of stroke, co-morbidity and the programme of
rehabilitation. Initial and final mRS results and the change (progress) of patients`
functional abilities and lengths of stay of both groups were recorded. Both groups
presented with lower mRS results at rehabilitation onset (4.06±1.02 in Croatian
and 3.88±0.96 in Bulgarian patients) indicating high dependency and the need
for thorough approach and engagement of the whole rehabilitation team. There
were significant changes of mRS (improvement) in both groups, but the progress
was statistically better in Croatian with change of mRS of 0.96±0.67, than in
Bulgarian patients (0.42±0.50), whereas the length of stay was significantly longer
in Croatian patients (33±15 days) than in Bulgarian (8±2 days). The change in
Stručni rad
Professional article
ISSN 1846-1867
Fiz. rehabil. med. 2012; 24 (3-4): 115-122 116
one mRS level may represent functionally important progress with significant
impact for the patient and his/her carers. Bulgarian patients, although significant in
before-after comparison of mRS results, do not reach functional goals as Croatian
patients. Therefore, we may suggest that the length of stay of Bulgarian patients
(8±2 days) should be prolonged to, at least, the length of stay present in Croatian
patients (33±15 days) to achieve the same functional improvement measured by
the modified Rankin scale.
Keywords
stroke; outcome; modified Rankin scale
Hrčak ID:
107982
URI
Publication date:
25.2.2013.
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