Predicting the outcome of specialist rehabilitation after non-traumatic subarachnoid haemorrhage: a multicentre cohort analysis from the UK Rehabilitation Outcomes Collaborative (UKROC) database

Background and methods

Non-traumatic subarachnoid haemorrhage (ntSAH) is associated with high mortality and disability. This cohort analysis aims to assess the impact of inpatient rehabilitation after ntSAH using the UK Rehabilitation Outcomes Collaborative database 2012–2023. Patients who gained a Minimal Clinically Important Difference (MCID) of 26.2 on functional independence (UK Functional Independence Measure+Functional Assessment Measure (UK FIM+FAM)) were compared with those who did not, using binary logistic regression to assess for predictors of positive outcomes.

Results

Among 2928 patients with ntSAH (1209 men and 1719 women, mean age 58 years (SD 13.2)), 1287 achieved MCID. Following inpatient rehabilitation, the mean total UK FIM+FAM improved by 42.3 points (95% CI 41.0 to 43.6, p=0.001), care needs reduced by a mean of 26.6 hours/week (95% CI 25.2 to 28.1, p=0.001) and care costs by a mean of £1998/week (95% CI 1872 to 2124, p=0.001). Admission to rehabilitation within 30 days of referral was associated with achieving MCID (1.638–2.673, p<0.001). Achieving MCID in either cognitive (1.730–3.180, p<0.001) or motor (1.527–4.893, p<0.001) subsections was associated with significantly increased odds of home discharge.

Conclusions

Rehabilitation improves functional outcomes following ntSAH. Predictors of achieving MCID include ethnicity, time from referral to admission and admission Patient Categorisation Tool scores. Predictors of home discharge include length of stay, dependency on admission and achieving MCID in Motor and/or Cognitive FIM domains.