Tooth Leigh, McKenna Kryss, Goh Kong, Varghese Paul
School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
Stroke. 2005 Jul;36(7):1519-25. doi: 10.1161/01.STR.0000169923.57038.a8. Epub 2005 May 26.
Although implemented in 1998, no research has examined how well the Australian National Subacute and Nonacute Patient (AN-SNAP) Casemix Classification predicts length of stay (LOS), discharge destination, and functional improvement in public hospital stroke rehabilitation units in Australia.
406 consecutive admissions to 3 stroke rehabilitation units in Queensland, Australia were studied. Sociodemographic, clinical, and functional data were collected. General linear modeling and logistic regression were used to assess the ability of AN-SNAP to predict outcomes.
AN-SNAP significantly predicted each outcome. There were clear relationships between the outcomes of longer LOS, poorer functional improvement and discharge into care, and the AN-SNAP classes that reflected poorer functional ability and older age. Other predictors included living situation, acute LOS, comorbidity, and stroke type.
AN-SNAP is a consistent predictor of LOS, functional change and discharge destination, and has utility in assisting clinicians to set rehabilitation goals and plan discharge.
尽管澳大利亚国家亚急性和非急性患者（AN-SNAP）病例组合分类于1998年开始实施，但尚无研究考察其对澳大利亚公立医院卒中康复单元住院时间（LOS）、出院去向及功能改善情况的预测效果如何。
对澳大利亚昆士兰州3个卒中康复单元连续收治的406例患者进行研究。收集社会人口学、临床及功能数据。采用一般线性模型和逻辑回归分析评估AN-SNAP预测结局的能力。
AN-SNAP对各项结局均有显著预测作用。住院时间延长、功能改善较差及出院后接受护理等结局与反映功能能力较差和年龄较大的AN-SNAP类别之间存在明确关联。其他预测因素包括生活状况、急性住院时间、合并症及卒中类型。
AN-SNAP是住院时间、功能变化及出院去向的一致性预测指标，有助于临床医生制定康复目标和规划出院安排。
