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Individuals with hemorrhagic stroke are frequently left with disability. There are gaps in knowledge in prognostication of recovery after hemorrhagic stroke. This scoping review aims to characterize predictive value of current models examining early predictors of long-term recovery in adults after hemorrhagic stroke. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines were followed. Four databases (PubMed, CINAHL, Web of Science, and Embase) were searched. Studies were included if greater than or equal to 60% of individuals had hemorrhagic stroke and identified early (≤30 days) predictors of long-term (≥6 months) recovery in adults after hemorrhagic stroke. Data regarding predictors and functional outcomes were extracted by at least two reviewers. Of 1155 articles, 31 were included. One study found that motor tract integrity, age, and hemorrhage volume explained 34.5% of the variance in functional outcomes. Of 31 studies, 30 did not provide overall predictive ability of the models tested but highlighted individual predictors independent of the others. Older age, worse severity, and higher comorbidities were associated with worse outcomes. Most outcome measures assessed gross function but gave little detail about specific functional performance. Only 12.9% (4/31) of studies included performance-based predictors. Functional and cognitive status were predictive of outcomes, indicating importance of more detailed functional assessments. There is a gap in the literature for prediction in hemorrhagic stroke. There is a need for further research to identify predictive value of both clinical and performance-based measures and to provide actionable models after hemorrhagic stroke to better inform rehabilitation approaches and promote more individualized care.
Casertano et al. (Fri,) studied this question.