OBJECTIVE Assess the association of time to initiation of acute rehabilitation therapy with disability following intracerebral hemorrhage (ICH) and to identify predictors of time to initiation of rehabilitation therapy. DESIGN Retrospective data analysis of prospectively collected data from an ongoing observational cohort study SETTING: Large comprehensive stroke center in a metropolitan area PARTICIPANTS: Adults with ICH consecutively admitted (n=203) INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Disability was assessed with the modified Rankin Scale (mRS), with poor outcome defined as mRS 4-6 (dependence or worse). Time to initiation of acute rehabilitation therapy was defined as the number of days between hospital admission and the first consult by any rehabilitation therapy specialist (e.g., physical therapy, occupational therapy, speech therapy). RESULTS The median number of days from hospital admission to initiation of acute rehabilitation therapy was 3 [2 - 7] days. Multivariable logistic regression models indicated that each additional day between admission and initiation of acute rehabilitation therapy was associated with increased odds of poor outcome at 30 days (adjusted-OR=1.151, 95% CI: 1.044-1.268, p=0.005) and at 90 days (adjusted-OR=1.107, 95% CI: 1.003-1.222, p=0.044) for patients with ICH. A multivariable linear regression model used to identify the predictors of time to initiation of rehabilitation therapy identified heavy drinking (>5 drinks per day)e, pre-morbid mRS < 4, presence of pulmonary embolism and longer length of stay in ICU as independent predictors of later initiation of acute rehabilitation therapy. CONCLUSION Longer time to initiation of acute rehabilitation therapy following ICH may have persistent effects on post-stroke disability. Delays in acute rehabilitation therapy consults should be minimized and may improve outcomes after ICH.

中文翻译：

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急性康复治疗前更长的时间会加重脑出血后的残疾

目的 评估开始急性康复治疗的时间与脑出血 (ICH) 后残疾的相关性，并确定开始康复治疗的时间的预测因素。设计 对一项正在进行的观察性队列研究前瞻性收集的数据进行回顾性数据分析 设置：大都市区的大型综合卒中中心 参与者：连续入院的 ICH 成人（n=203） 干预：不适用Rankin 量表 (mRS)，预后不良定义为 mRS 4-6（依赖或更差）。开始急性康复治疗的时间定义为从入院到任何康复治疗专家（例如，物理治疗、职业治疗、言语治疗）。结果 从入院到开始急性康复治疗的中位天数为 3 [2 - 7] 天。多变量逻辑回归模型表明，入院和开始急性康复治疗之间每多一天与 30 天（调整后的 OR=1.151，95% CI：1.044-1.268，p=0.005）和 90 ICH 患者的天数（调整后的 OR=1.107，95% CI：1.003-1.222，p=0.044）。用于确定开始康复治疗时间的预测因素的多变量线性回归模型将酗酒（每天 > 5 杯）e、病前 mRS < 4、存在肺栓塞和在 ICU 中停留的时间延长作为独立预测因素后期开始急性康复治疗。结论 ICH 后开始急性康复治疗的时间较长可能对卒中后残疾具有持续影响。应尽量减少急性康复治疗咨询的延误，并可能改善 ICH 后的结果。