Functional status and its related factors among stroke survivors in rehabilitation departments of hospitals in Shenzhen, China: a cross-sectional study

Background: Many stroke survivors have multiple chronic diseases and complications coupled with various other factors which may affect their functional status. We aimed to investigate the factors associated with poor functional status in hospitalized patients with stroke in Shenzhen, China.

Methods: In this cross-sectional study, four urban hospitals were selected using convenient sampling, and all stroke patients in these four hospitals were included using cluster sampling. The functional status of stroke survivors was evaluated using Longshi Scale. Explanatory variables (factors affecting functional status comprising age, sex, body mass index, smoking, alcohol consumption, complications, and chronic conditions) were collected. Ordinal logistic regression was used to examine which factors were associated with poor functional status.

Results: Stroke survivors with poor functional status accounted for 72.14% and were categorised as the bedridden group based on Longshi scale, 21.67% of patients with moderate functional limitation were categorised as the domestic group, and 6.19% of the patients with mild functional restriction were categorised as the community group. The highest dependence scores were noted for feeding (73.39%), bowel and bladder management (69.74%) and entertainment (69.53%) among the bedridden group, and housework (74.29%) among the domestic group. In the adjusted model, the odds of poor functional status were higher among stroke patients with older age (odds ratio [OR] = 2.39, 95% CI: 1.55-3.80), female sex (OR = 1.73, 95% CI: 1.08-2.77), duration of stroke more than 12 months (OR = 1.94, 95% CI: 1.28-2.95), with pulmonary infection (OR = 10.91, 95% CI: 5.81-20.50), and with deep venous thrombosis (OR = 3.00, 95% CI: 1.28-7.04).

Conclusions: Older adults (age ≥ 60 years) and women were more likely to exhibit poor functional status post-stroke. Pulmonary infection and deep venous thrombosis were related to an increased risk of being dependent on activities of daily living. Therefore, clinical and rehabilitation interventions aimed at preventing or treating these common complications should be addressed to deal with subsequent dysfunction post-stroke. Since all data were obtained in metropolitan areas where the economy is well developed, future studies should be conducted in rural areas and economically less developed cities.