Neurorehabilitation Unit, Geriatric Competence Center, Felix Platter-Spital, Basel, Switzerland. matthias.frank @ fps-basel.ch
Eur Neurol. 2010;63(4):227-33. doi: 10.1159/000279491. Epub 2010 Mar 10.
BACKGROUND/AIMS: Returning home is one of the most important aims of stroke patients when admitted to rehabilitation.
A single-center prospectively ascertained database study was conducted.
Among 1,332 eligible patients (median age = 76.5 years), 828 (62.2%) returned home. Multiple logistic regression revealed 5 independent predictors: independent sitting balance, higher motor and social-cognitive functional independence measure subscores (all on admission to rehabilitation), living with a partner and younger age. The area under the curve (AUC) of this model was 0.86 (95% confidence interval (CI) 0.84-0.88). When age was excluded from the model, the AUC remained virtually the same (AUC = 0.85, 95% CI = 0.83-0.87).
The discharge destination could be predicted in a majority of patients with easily available parameters. Availability of a partner as well as parameters linked to severity of the neurological and functional deficit were both important. Age alone adds very little to the predictive power of these variables, therefore access to rehabilitation should not be denied on grounds of age.
背景/目的：脑卒中患者入院康复的最重要目标之一是返回家中。
进行了一项单中心前瞻性确定的数据库研究。
在 1332 名合格患者中（中位数年龄=76.5 岁），828 名（62.2%）患者返回家中。多因素逻辑回归显示 5 个独立的预测因素：独立坐立平衡、较高的运动和社会认知功能独立性测量亚量表评分（所有评分均在康复入院时）、与伴侣同住和年龄较小。该模型的曲线下面积（AUC）为 0.86（95%置信区间（CI）为 0.84-0.88）。当从模型中排除年龄时，AUC 几乎保持不变（AUC=0.85，95%CI=0.83-0.87）。
可以根据易于获得的参数预测大多数患者的出院目的地。有伴侣以及与神经和功能缺损严重程度相关的参数都很重要。年龄本身对这些变量的预测能力贡献甚微，因此不应因年龄原因拒绝康复治疗。
