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BMC Neurology

, 14:34

Cerebrovascular disease and stroke


BackgroundColonization with MRSA is believed to have deteriorating effects on neurological rehabilitation patients because MRSA carriers need to be isolated.

MethodsMedical records of neurological early rehabilitation patients most of them after stroke admitted to a large rehabilitation facility in Northern Germany in 2010 have been carefully reviewed with respect to MRSA status, outcome variables functional independence, morbidity, and length of stay LOS.

Results74-569 13.0% patients were MRSA positive on admission. MRSA carriers had a significantly longer LOS in early neurological rehabilitation 63.7 37.1 vs. 25.8 24.5 days, p < 0.001, worse functional status on admission Barthel index BI 13.6 9.9 vs. 25.6 24.1, p < 0.001, worse Glasgow Coma Scale 9.5 3.2 vs. 12.0 3.3, p < 0.001, more co-diagnoses 20.5 5.1 vs. 13.3 5.5, p < 0.001, and higher Patient Clinical Complexity Levels PCCL. The outcome was significantly worse among MRSA positive patients BI 25.5 21.2 vs. 47.4 31.0, p < 0.001; Early Rehabilitation Index −47.3 51.4 vs. -26.0 35.4, p < 0.001. Isolated patients had slightly less therapy per day 131.6 16.6 vs. 140.2 18.7 min-day, p < 0.001, but the overall sum of therapy was significantly larger in the MRSA positive group due to longer LOS.

ConclusionsFunctional recovery of MRSA carriers in early neurological rehabilitation is worse than in MRSA negative patients. Poorer outcome is not resulting from isolation less therapy but from functional status and higher morbidity on admission.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-14-34 contains supplementary material, which is available to authorized users.

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Autor: Jens D Rollnik

Fuente: https://link.springer.com/

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