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A model to aid in the prediction of discharge location for stroke rehabilitation patients

AGARWAL V; MCRAE MP; BHARDWAJ A
ARCH PHYS MED REHABIL , 2003, vol. 84, n° 11, p. 1703-1709
Doc n°: 111018
Localisation : Documentation IRR
Descripteurs : AF21 - ACCIDENTS VASCULAIRES CEREBRAUX
Article consultable sur : http://www.archives-pmr.org

OBJECTIVE: To determine which demographic and medical factors recorded on admission to a rehabilitation unit best predict discharge accommodation outcomes. DESIGN: Retrospective chart review. SETTING: Inpatient rehabilitation unit in an academic hospital in southwestern Ontario, Canada. PARTICIPANTS: One hundred four stroke patients (54 women, 50 men; mean age, 72.0y) admitted to the rehabilitation unit over a 4-year period. INTERVENTIONS: All patients underwent evaluations by the physical therapy, occupational therapy, social work, speech pathology, and psychology departments. Patients were divided into 2 groups: (1) no change in premorbid accommodation and (2) change in premorbid accommodation. MAIN OUTCOME MEASURES: Demographic, clinical, and housing information (premorbid, discharge) and functional data (FIM trade mark instrument, Chedoke-McMaster Stroke Assessment [CMSA] Impairment Inventory, Berg Balance Scale [BBS]) were recorded for each patient. RESULTS: Of 104 patients, 24 were discharged with a change in premorbid accommodation. Change in discharge location was significantly associated with age, gender, and the presence of premorbid social support (P<.01), but not with type of premorbid living arrangement. Statistically significant differences were noted between total FIM scores (P<.001), BBS scores (P<.001), and the postural component of the CMSA Impairment Inventory (P<.03). A logistic regression model, predicting 67% of the variance, was created to predict discharge accommodations. CONCLUSIONS: Patients admitted to the rehabilitation unit can be scored to obtain their predicted chance of being discharged with a change from their premorbid accommodations. The equation is relatively easy to calculate and is based on data that are commonly collected in rehabilitation. "

Langue : ANGLAIS

Identifiant basis : 2004229085

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