1Raymond Poincaré Hospital, AP-HP, University of Versailles Saint Quentin, Garches, France.
Neurorehabil Neural Repair. 2014 Jan;28(1):36-44. doi: 10.1177/1545968313497828. Epub 2013 Jul 29.
In France in 2009, patients admitted to Multidisciplinary Inpatient Rehabilitation for stroke were sent to a neurological rehabilitation center (NRC) or a general or geriatric rehabilitation (GRC) service.
To describe the functional outcome of stroke patients admitted for rehabilitation in France in 2009, both globally and as a function of the rehabilitation setting (GRC or NRC).
Data from the French Hospital Discharge Diagnosis databases for 2009 were included. Two logistic regression models were used to analyze factors related to improvement in dependence score and discharge home. Odds ratios (ORs) were also calculated.
Among the 83 505 survivors of acute stroke in 2009, 28 201 were admitted for rehabilitation (33.8%). Of these, 19 553 went to GRC (69%) and 8648 to NRC (31%). On average, patients admitted to GRC were older (78.6 years vs 66.4 years), P < .001). At the start of rehabilitation, 50% of NRC patients and 56% of GRC patients were heavily dependent, but level of dependence was similar within each age-group. Rehabilitation in NRC lead to a greater probability of functional improvement (OR = 1.75, P < .001) and home discharge (OR = 1.61, P < .001) after adjustment for gender, age, Charlson's comorbidity index, initial level of dependence, type of stroke, and total length of stay.
This study confirms, on a national level, the functional benefit of specialized rehabilitation in NRC. These results should be useful in the improvement of care pathways, organization of rehabilitation, and discharge planning.
2009 年在法国，因中风住院接受康复治疗的患者被送往神经康复中心（NRC）或综合或老年康复（GRC）机构。
描述 2009 年在法国接受康复治疗的中风患者的功能结局，既包括整体情况，也包括康复环境（GRC 或 NRC）的功能。
纳入 2009 年法国医院出院诊断数据库的数据。使用两个逻辑回归模型分析与依赖评分改善和出院回家相关的因素。还计算了比值比（OR）。
在 2009 年急性中风幸存者中，有 83505 人接受了康复治疗（33.8%）。其中，28201 人入住 GRC（69%），8648 人入住 NRC（31%）。一般来说，入住 GRC 的患者年龄较大（78.6 岁比 66.4 岁），P<0.001）。在康复开始时，50%的 NRC 患者和 56%的 GRC 患者严重依赖，但每个年龄组的依赖程度相似。调整性别、年龄、Charlson 合并症指数、初始依赖程度、中风类型和总住院时间后，NRC 的康复治疗更有可能提高功能（OR=1.75，P<0.001）并出院回家（OR=1.61，P<0.001）。
本研究在国家层面上证实了 NRC 中专门康复治疗的功能效益。这些结果对于改善护理途径、康复组织和出院计划将非常有用。
