Murie-Fernandez M, Ortega Cubero S, Carmona Abellan M, Meyer M, Teasell R. Tiempo es cerebro ¿solo en la fase aguda del ictus?. Neurologia 2012 May;27(4):234-244.
Introduction and objective: In Spain, stroke is the leading cause of death in women as well as
the leading cause of disability in adults. This translates into a huge human and economic cost.
In recent years there have been significant advances both in the treatment of acute stroke and
in the neuro-rehabilitation process; however, it is still unclear when the best time is to initiate
neurorehabilitation and what the consequences of delaying treatment are. To test the effect
of a single day delay in the onset of neurorehabilitation on functional improvement achieved,
and the influence of that delay in the rate of institutionalisation at discharge.
Methods: A retrospective study of patients admitted to Parkwood Hospital’s Stroke Neurorehabilitation
Unit (UNRHI) (University of Western Ontario, Canada) between April 2005 and
September 2008 was performed. We recorded age, Functional Independence Measurement (FIM)
score at admission and discharge, the number of days between the onset of stroke and admission
to the Neurorehabilitation Unit and discharge destination.
Results: After adjustment for age and admission FIM, we found a significant association between
patient functional improvement (FIM gain) and delay in starting rehabilitation. We also
observed a significant correlation between delay in initiating therapy and the level of institutionalisation
Conclusions: A single day delay in starting neurorehabilitation affects the functional prognosis
of patients at discharge. This delay is also associated with increased rates of institutionalisation