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新加坡急性中风患者住院康复住院时间的预测因素。

Factors predicting inpatient rehabilitation length of stay of acute stroke patients in Singapore.

作者信息

Tan Woan Shin, Heng Bee Hoon, Chua Karen Sui-Geok, Chan Kay Fei

机构信息

Health Services and Outcomes Research Department, National Healthcare Group, Singapore.

出版信息

Arch Phys Med Rehabil. 2009 Jul;90(7):1202-7. doi: 10.1016/j.apmr.2009.01.027.

Abstract

OBJECTIVE

To determine the predictors of hospital length of stay (LOS) of stroke patients at the point of admission.

DESIGN

A retrospective cohort study.

SETTING

An acute hospital rehabilitation center in Singapore.

PARTICIPANTS

Stroke patients (N=491) admitted between March 2005 and December 2006.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Rehabilitation LOS was calculated as the total number of rehabilitation days before discharge. We measured the functional status of patients by using the Functional Independence Measure (FIM).

RESULTS

The median LOS was 29 days (mean = 30.8d). Independent clinical and sociodemographic characteristics found to significantly predict rehabilitation LOS were FIM motor score at admission, the presence of more than 3 comorbid conditions at admission, living with nonimmediate relatives before admission, and the hospital subsidy status of the patient. In particular, the admission FIM motor score explained 43% of the variation in LOS and decreased the LOS by approximately 1.1 days for each 1-point increase in score.

CONCLUSION

Patients' socioeconomic status and family structure was found to influence LOS and should be considered in allocating resources and determining treatment need. The extent of motor function of patients at admission is an important factor influencing rehabilitation LOS and is a useful tool for facilitating rehabilitation resource planning for stroke patients.

摘要

目的

确定卒中患者入院时住院时间(LOS)的预测因素。

设计

一项回顾性队列研究。

地点

新加坡的一家急性医院康复中心。

参与者

2005年3月至2006年12月期间入院的卒中患者(N = 491)。

干预措施

无。

主要观察指标

康复住院时间计算为出院前康复天数的总和。我们使用功能独立性测量(FIM)来评估患者的功能状态。

结果

中位住院时间为29天(平均 = 30.8天)。发现显著预测康复住院时间的独立临床和社会人口统计学特征为入院时的FIM运动评分、入院时存在3种以上合并症、入院前与非直系亲属同住以及患者的医院补贴状况。特别是,入院时的FIM运动评分解释了住院时间变化的43%,评分每增加1分,住院时间减少约1.1天。

结论

发现患者的社会经济状况和家庭结构会影响住院时间,在分配资源和确定治疗需求时应予以考虑。患者入院时的运动功能程度是影响康复住院时间的一个重要因素,是促进卒中患者康复资源规划的一个有用工具。

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