Article

The aim of this study was to develop an index for establishing the
probability of being discharged home after hospitalization for acute stroke using
information about previous living circumstances, comorbidities, hospital course,
and the physical grades and cognitive stages of independence achieved.
This is a longitudinal observational population-based study. All 6515 persons
treated for acute stroke who received rehabilitation services in 110 Veterans
Affairs facilities within a 2-yr period were included. RESULTS: There were eight
independent predictors of home discharge identified, and points were assigned
through logistic regression: married (2 points); location before hospitalization
(extended care = 0 points, other hospital = 9 points, home = 11 points);
discharge physical grade (grade I, II, or III = 0 points; grade IV or V = 3
points; grade VI or VII = 5 points); discharge cognitive stage (stage I = 0
points; stage II, III, IV, or V = 3 points; stage VI or VII = 5 points); and
absence of liver disease (2 points), mechanical ventilation (3 points), nonoral
feeding (2 points), and intensive care unit admission (1 point). The points were
added for all present factors to calculate scores. The probabilities of home
discharge ranged from 65.03% in the least likely (</=21 points) to 98.24% in the
most likely group (>/=27 points). CONCLUSIONS: The treatment team might apply
prognostic estimates from this index in discharge planning and functional goal
setting after initial physical medicine and rehabilitation assessment.

Langue : ANGLAIS