Article

OBJECTIVE: To identify patient-level characteristics associated with
rehabilitation during the acute poststroke phase. DESIGN: Retrospective cohort.
Generalized estimating equations modeled the likelihood of rehabilitation during
the index hospitalization to account for patient clusters. SETTING:
Rehabilitation facilities. PARTICIPANTS: Sample included veterans (N=9681;
average age, 68.7y; 97.4% men) diagnosed with new stroke discharged from Veterans
Affairs hospitals between October 1, 2006, and September 30, 2008. INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURE: Receipt of rehabilitation services.
RESULTS: Of the total cohort, 73% received some type of rehabilitation. After
adjustment, stroke patients with cerebral arteries occlusion were most likely to
receive rehabilitation compared with other stroke types (P<.001). Patients with
prestroke conditions of metastatic cancer (odds ratio [OR]=.68, P<.001) and
psychosis (OR=.90, P=.045) were less likely to have rehabilitation, whereas those
with hypertension (OR=1.26, P<.001) and other neurologic disorders (OR=1.29,
P<.001) were more likely. Compared with patients admitted from home, patients
transferred from a non-Veterans Affairs hospital (OR=1.4, P<.004) were more
likely to receive rehabilitation, whereas patients admitted from extended care
(OR=.59, P<.001) were less likely. Married veterans were less likely to receive
rehabilitation services (OR=.87, P<.001) than unmarried veterans. CONCLUSIONS:
Within the Veterans Health Administration, initiating rehabilitation in the acute
phase poststroke appears to be influenced by patient clinical characteristics and
living circumstances.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
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Langue : ANGLAIS