School of Medicine, Washington University in St. Louis, MO 63108, USA.
Am J Phys Med Rehabil. 2013 Jul;92(7):627-34. doi: 10.1097/PHM.0b013e318282bc0d.
Although returning to driving is a major concern for many survivors of stroke, predicting who will return to driving after a stroke is often difficult for rehabilitation professionals. The primary aim of this study was to identify patient factors present at admission to an inpatient rehabilitation hospital that can be used to identify which patients who have had acute stroke will and will not return to driving.
After comparing returners and nonreturners on demographic and clinical characteristics, a logistic regression model with return to driving as the outcome variable was built using the backward stepwise method.
Thirty-one percent (48/156) of the patients who had been driving before their stroke returned to driving 6 mos after stroke. The final regression model, using Functional Independence Measure cognition and lower extremity Motricity Index scores, predicted the driving outcome with an accuracy of 75% (107/143).
Patients with lower Functional Independence Measure cognition and lower extremity Motricity Index scores at admission to inpatient rehabilitation are less likely to return to driving at 6 mos. This model could be used by rehabilitation professionals to help counsel patients and their families and focus treatment goals.
尽管许多脑卒中幸存者都非常关注能否重新开车，但康复专业人员往往难以预测哪些患者在脑卒中后能够重新开车。本研究的主要目的是确定患者在入院时存在的哪些因素可以用来识别哪些急性脑卒中患者可以或不可以重新开车。
将脑卒中后重新开车的患者与未重新开车的患者进行比较，根据回归模型建立方法，采用向后逐步回归方法建立以能否重新开车为因变量的逻辑回归模型。
在脑卒中前有开车史的 156 例患者中，31%（48/156）在脑卒中后 6 个月时恢复了驾驶能力。使用功能独立性测量认知和下肢运动指数评分的最终回归模型对 143 例患者中的 107 例（75%）的驾驶结局进行了预测。
在进入住院康复治疗时，功能独立性测量认知和下肢运动指数评分较低的患者在 6 个月时重新开车的可能性较小。该模型可由康复专业人员用于帮助患者及其家属咨询，并确定治疗目标。
