Massucci Maurizio, Perdon Luigi, Agosti Maurizio, Celani Maria Grazia, Righetti Enrico, Recupero Egidio, Todeschini Elisabetta, Franceschini Marco
Department of Rehabilitation, Hospital of Passignano, Passignano, Italy.
Am J Phys Med Rehabil. 2006 Dec;85(12):963-70. doi: 10.1097/01.phm.0000242620.44924.1b.
The aim of this study was to identify predictive variables related to activity limitation and home destination of a large sample of first-time stroke patients at discharge from a rehabilitation hospital.
A multicenter observational study was conducted among 1023 first-time stroke patients who were admitted to 18 different Italian inpatient rehabilitation centers between February 1999 and November 2000. Only 997 patients were considered eligible. At admission, sociodemographic and clinical data were considered as independent variables. The outcome measures evaluated the ability to become functionally independent (independence gain [Barthel Index score > or =18]) at discharge and home return.
The study data suggest that independence gain is associated with an earlier rehabilitation intervention, being male, and low or absent cognitive deficit. Home return is associated with no indwelling bladder catheterization, no dysphagia, and living with a companion (roommate or family member) before the stroke.
In postacute stroke rehabilitation, level of cognitive impairment, bladder dysfunction and dysphagia, early diagnosis and treatment, early rehabilitation intervention, and living status (whether the person was residing with a companion before the stroke) are important criteria for outcome measurement at the time of admission. These previous characteristics will most certainly provide clinicians with useful information during the acute phase.
本研究旨在确定与康复医院出院时大量首次中风患者的活动受限及家庭去向相关的预测变量。
对1999年2月至2000年11月期间入住18家不同意大利住院康复中心的1023例首次中风患者进行了一项多中心观察性研究。仅997例患者被认为符合条件。入院时，社会人口统计学和临床数据被视为自变量。结局指标评估出院时功能独立（独立获得[Barthel指数评分≥18]）及回家的能力。
研究数据表明，独立获得与早期康复干预、男性以及认知缺陷程度低或无认知缺陷有关。回家与无留置膀胱导尿、无吞咽困难以及中风前与同伴（室友或家庭成员）同住有关。
在急性中风后康复中，认知障碍程度、膀胱功能障碍和吞咽困难、早期诊断和治疗、早期康复干预以及生活状况（中风前是否与同伴同住）是入院时结局测量的重要标准。这些先前的特征肯定会在急性期为临床医生提供有用信息。
