Predictors of Short-Term Functional Outcomes of Stroke Patients Admitted to Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: A Prospective Cohort Study

Abstract

Background: Stroke is a leading cause of adult disability worldwide, with motor impairments such as hemiparesis significantly reducing quality of life. Identifying clinical and sociodemographic predictors of short-term functional recovery is essential to optimize rehabilitation strategies, especially in resource-limited settings like Ethiopia. Objective: To identify predictors of short-term functional outcomes among stroke patients admitted to Saint Paul’s Hospital Millennium Medical College from May 1 to October 30, 2023. Methods: This prospective cohort study enrolled 152 consecutive adult stroke patients confirmed by clinical and radiological criteria. Functional recovery was assessed at three weeks post-stroke using the Functional Independence Measure (FIM). Data on demographics, stroke characteristics, comorbidities, physiotherapy care (enrolment, timing, intensity), and hospital service factors were collected. Bivariate and multivariate logistic regression analyses identified independent predictors of functional improvement. Results: Among participants, 39.5% received physiotherapy during hospitalization. Physiotherapy enrolment was strongly associated with improved short-term functional recovery (adjusted odds ratio [AOR] = 5.36; 95% confidence interval [CI], 4.50–10.75; p = 0.006). Greater physiotherapy intensity (total hours) also predicted better outcomes (AOR = 1.35; 95% CI, 1.17–1.56; p < 0.001). Older age, presence of comorbidities, and in-hospital complications were negatively associated with recovery. Timing of physiotherapy initiation was not significantly linked to outcomes. Conclusion: Physiotherapy enrolment and intensity are key determinants of short-term functional recovery after stroke. Expanding access and ensuring adequate rehabilitation dosage should be prioritized in stroke care protocols in Ethiopia. Keywords : Stroke, Functional outcome, Physiotherapy, Rehabilitation, Ethiopia.