Background: There is limited information on long term effects on quality of life after severe stroke followed by early institutional rehabilitation. 
Methods: Analysis of the Asklepios Hamburg multicenter early stroke rehabilitation registry. Phone interviews three and twelve month after discharge were performed to record early rehabilitation Barthel index (ERBI), 12-Item Short Form Health Survey (SF-12) and further treatment and complications. We used descriptive statistics as well as t-test, Kendall`s method and an ordinal logistic model.
Results: 270 stroke patients were enrolled between 10/2015 and 11/2017 and contacted until 02/2018. 200 and 151 patients could be followed up after 3 and 12 months, respectively. 70 and 12 patients were lost in follow-up, 14 and 28 patients died after 3 and 12 months, respectively. There was a significant improvement (p <0.001) in the median ERBI (151 survivors at 12 months: admission in early rehabilitation: -10, discharge +30, 3 months: +45, 12 months: +55). Factors influencing a higher modified Rankin Scale (mRS) at 12 months were age (per decade OR 1.5 [1.09, 2.02], p = 0.01) and higher mRS at discharge (OR 5.43 [1.18, 25.09], p = 0.03). Female sex reduced the risk for worse outcome (OR 0.49 [0.25, 0.96], p = 0.04). Quality of life (QOL, SF12) did not change significantly (3 vs. 12 months). Mental QOL was no different compared to a historically low-handicapped collective (Lingnau and Hesse 2004), physical QOL was expected to be significantly lower (p <0.001).

Conclusions: Surviving severe stroke patients recover significantly up to 12 months after discharge. The mental QOL surprisingly does not differ from a historical stroke collective despite lower physical QOL.

Acknowledgment: The study is sponsored by Asklepios Kliniken Hamburg.

LONG TERM QUALITY OF LIFE AND DISABILITY AFTER EARLY INSTITUTIONAL REHABILITATION OF SEVERE STROKE