Suputtitada A, Aksaranugraha S, Granger C V, Sankaew M
Department of Rehabilitation Medicine, Chulalongkorn University, Bangkok, Thailand.
Disabil Rehabil. 2003 Oct 7;25(19):1140-5. doi: 10.1080/0963828031000152039.
The purpose of this study is to identify predictors of functional outcome after acute to sub-acute stroke rehabilitation using raw FIM score and results of stroke rehabilitation in Thailand.
Descriptive and multivariate analysis was performed on data collected prospectively from 50 patients who were on stroke rehabilitation at Thai Red Cross Rehabilitation Center from October 1, 2000 to September 30, 2001. Six independent variables were obtained from patients' medical records.
The total FIM scores at the time of discharge and total FIM scores gain are strongly correlated with the total FIM scores at the time of admission to the hospital and correlated negatively with age using multiple linear regression analysis, significant at p < 0.05. The equation for all cases were: (discharge total FIM scores) = 82.856 + 0.708 x (admission total FIM scores) - 0.408 x (age) and (total FIM scores gain) = 82.85 - 0.292 x (admission total FIM scores) - 0.408 x (age). The models explained 76.48% of variation for total FIM scores at the time of discharge and 45.66% of variation for total FIM scores gain. The total FIM scores at the time of admission and age were the best predictors of the total FIM score at the time of discharge and the total FIM scores gain. However, the nature of stroke, gender, onset to admission interval (OAI), and length of rehabilitation stay (LOS) were not statistically significantly correlated with the total FIM scores at the time of discharge and the total FIM scores gain.
Because the total FIM score at the time of discharge and the total FIM scores gain are highly correlated with the total FIM scores at the time of admission and age, we can inform the patient and their family about the possibility of recovery, and assess the amount and quality of care needed at home or placement after discharge.
本研究旨在利用原始FIM评分及泰国脑卒中康复结果,确定急性至亚急性脑卒中康复后功能结局的预测因素。
对2000年10月1日至2001年9月30日在泰国红十字会康复中心接受脑卒中康复治疗的50例患者前瞻性收集的数据进行描述性和多变量分析。从患者病历中获取六个自变量。
出院时的FIM总分及FIM总分增加值与入院时的FIM总分密切相关,且与年龄呈负相关,采用多元线性回归分析,p<0.05时有显著性差异。所有病例的方程为:(出院时FIM总分)=82.856+0.708×(入院时FIM总分)-0.408×(年龄),(FIM总分增加值)=82.85-0.292×(入院时FIM总分)-0.408×(年龄)。这些模型解释了出院时FIM总分变异的76.48%以及FIM总分增加值变异 的45.66%。入院时的FIM总分和年龄是出院时FIM总分及FIM总分增加值的最佳预测因素。然而,脑卒中的性质、性别、发病至入院间隔时间(OAI)以及康复住院时间(LOS)与出院时的FIM总分及FIM总分增加值在统计学上无显著相关性。
由于出院时的FIM总分及FIM总分增加值与入院时的FIM总分和年龄高度相关,我们可以告知患者及其家属康复的可能性,并评估出院后在家中或安置机构所需护理的数量和质量。