Article

This study aimed to identify factors that assessors
considered important in decision-making regarding suitability
for inpatient rehabilitation after acute severe stroke.
Multi-site prospective observational cohort study.
Subjects: Consecutive acute, severe stroke patients and their
assessors for inpatient rehabilitation.
Methods: Rehabilitation assessors completed a questionnaire,
rating the importance (10 point visual analogue scale)
and direction (positive, negative or neutral) of 15 patient related
and 2 organisational items potentially affecting their
decision regarding patients' acceptance to rehabilitation.
Results: Of the 75 patients referred to rehabilitation and included
in this study 61 (81.3%) were accepted for inpatient
rehabilitation. The items considered to be most important
in the decision to accept the patient for rehabilitation were
pre-morbid cognition, pre-morbid mobility and pre-morbid
communication. For those not accepted the most important
items were current mobility, social support and current cognition.
Factor analysis revealed 3 underlying factors, interpreted
as post-stroke status, pre-morbid status, and social
attributes, accounting for 61.8% of the total variance. All
were independently associated with acceptance for rehabilitation
(p < 0.05).
Conclusions: This study highlights the importance of premorbid
function and social factors in addition to post-stroke
function in the decision making process for acceptance to
rehabilitation following severe stroke. Future models for selection
for rehabilitation should consider inclusion of these
factors

Langue : ANGLAIS