Article

This study aimed to evaluate factors that help determine the
post-acute level of care for stroke patients with aspiration pneumonia (ASPNA).
DESIGN: This was a retrospective observational study of patients admitted to the
University of Texas at Houston Medical School Stroke Service between July 2004
and October 2009 with discharge dispositions of home, inpatient rehabilitation,
skilled nursing facility, or subacute care (n = 3511). Demographics, stroke risk
factors, and National Institutes of Health Stroke Scale (NIHSS) values were
collected. Interactions were evaluated between ASPNA and aging, ASPNA and NIHSS,
ASPNA and use of tube feeding, and ASPNA and history of stroke. Using
multivariable logistic regression, the data were analyzed for differences in
disposition among patients with ASPNA. RESULTS: There were significant
correlations between ASPNA and an NIHSSvalue of 7.44 or greater for discharge to
inpatient rehabilitation, skilled nursing facility, or subacute care compared
with discharge to home (P = 0.0138); between ASPNA and an NIHSS value of 10.93 or
greater for discharge to skilled nursing facility or subacute care compared with
inpatient rehabilitation (P < 0.0001); and between ASPNA and age greater than
69.30 yrs for discharge to subacute care compared with a skilled nursing facility
(P G 0.0001). CONCLUSIONS: Patients with ASPNA and an NIHSS value of 7.44 or
greater are more likely to require additional postacute care. ASPNA and an NIHSS
value of 10.93 or greater increased the chance of postacute care at a level
suggestive of lower functional status (skilled nursing facility or subacute care
compared with inpatient rehabilitation). Age greater than 69.30 yrs plus ASPNA
increased the likelihood of placement in subacute care vs. a skilled nursing
facility.

Langue : ANGLAIS