Background: Stroke rehabilitation improves functional recovery among stroke patients. However, little is known about clinical practice in China regarding the assessment and provision of rehabilitation among patients with acute ischemic stroke (AIS).
Aims: We examined the frequency and determinants of an assessment for rehabilitation among AIS patients from the China National Stroke Registry II.
Methods: Data for 19,294 AIS patients admitted to 219 hospitals from June 2012 to January 2013 were analyzed. The multivariable logistic regression model with the generalized estimating equation method accounting for in-hospital clustering was used to identify patient and hospitals factors associated with having a rehabilitation assessment during the acute hospitalization.
Results: Among 19,294 AIS patients, 11,451 (59.4%) were assessed for rehabilitation. Rehabilitation assessment rates varied considerably among centers: median 64.8% (interquartile range: 41.4%-83.3%). Factors associated with increased likelihood of a rehabilitation assessment in the multivariable model (p<0.05) included disability prior to this stroke, increasing NIHSS on admission, receiving dysphagia screening, deep venous thrombosis prophylaxis, and carotid vessel imaging, longer length of stay, and increasing hospital beds (per 100 units). In contrast, patients with a history of atrial fibrillation, and increasing annual stroke discharges (per 100 patients) were less likely to receive rehabilitation assessment during the acute stroke hospitalization.
Conclusions: Up to a third of patients in China do not receive rehabilitation assessment follow an AIS. Thus, there appears to be opportunities to improve adherence to recommended care for stroke survivors in China.