Article

The aim of this study was to determine whether functional status, as
measured by the AcuteFIM instrument, can be used to predict discharge destination
of stroke patients from the acute hospital setting.
DESIGN: A retrospective
cohort study was carried out in an urban academic medical center. Data were
collected on 481 new-onset stroke patients 18 yrs or older in an acute hospital
between January 1 and September 30, 2013. Functional Independence Measure (FIM)
instrument data were linked to a subset of 54 patients who received additional
services at an inpatient rehabilitation facility. A receiver operator
characteristic curve was constructed to validate the predictive ability of the
AcuteFIM instrument and to determine the optimal cutoff score associated with
discharge to a community setting. RESULTS: All AcuteFIM items in stroke patients
at admission demonstrated strong interitem correlation coefficients (all above
0.6) and high internal consistency (Cronbach alpha = 0.94). The AcuteFIM total
score was positively associated with discharge to the community from the acute
hospital (odds ratio, 1.06; 95% confidence interval, 1.05-1.07). Receiver
operator characteristic curve analysis generated a c statistic of 0.89 (95%
confidence interval, 0.87-0.92), indicating that the AcuteFIM instrument is
predictive of patient discharge to the community setting. CONCLUSION: This study
suggests that the AcuteFIM instrument is a reliable tool that can be used to
predict discharge destination from the acute hospital among stroke patients.

Langue : ANGLAIS