Taiwo Whitney, Wressle Alexandra, Bradley Lloyd
a Brighton and Sussex Medical School , Brighton , UK.
b Donald Wilson House Neurological Rehabilitation Centre , Western Sussex Hospitals NHS Trust , Chichester, UK.
Disabil Rehabil. 2018 Mar;40(5):548-552. doi: 10.1080/09638288.2016.1261419. Epub 2016 Dec 15.
A retrospective case series was performed to determine which measures of complexity, dependency and function most accurately predict inpatient neurorehabilitation length of stay for individuals with post-acute neurological disorders.
Sociodemographic, medical and functional variables were extracted from data submitted to the UK Rehabilitation Outcomes Collaborative. Length of stay was calculated as the total number of inpatient days, functional status was measured using Barthel Index, rehabilitation complexity was measured using Extended Rehabilitation Complexity Scale, and nursing dependency was measured using the Northwick Park Dependency Scale.
The mean rehabilitation length of stay was 70.9 days, with length of stay being 35.1 days higher in inpatients with acquired brain injury than inpatients with spinal cord injury. Diagnostic category, Barthel Index scores, Extended Rehabilitation Complexity Scale scores and Northwick Park Dependency Scale scores at admission independently predicted length of stay. Multiple regressions including diagnostic group, Barthel Index, Extended Rehabilitation Complexity Scale and Northwick Park Dependency Scale statistically significantly predicted 37.9% of the variability in length of stay (p < 0.005). Northwick Park Dependency Scale on admission was most closely correlated with inpatient length of stay.
In conclusion, inpatient length of stay is predicted by diagnostic category, Extended Rehabilitation Complexity Scale, Northwick Park Dependency Scale and Barthel Index. The most influential predictor of rehabilitation length of stay was Northwick Park Dependency Scale score at admission. These results may help facilitate rehabilitation resource planning and implementation of effective commissioning plans. Implications for Rehabilitation The most accurate predicting variable for length of stay in inpatient neurological rehabilitation was nursing need as measured by the Northwick Park Dependency Scale score on admission. Service users and commissioners can be provided with more realistic predictions of length of stay derived from admission variables that can be used in planning inpatient rehabilitation. Age and gender do not seem to have an effect on the total length of stay in rehabilitation.
开展一项回顾性病例系列研究，以确定哪些复杂性、依赖性和功能指标能最准确地预测急性神经疾病患者的住院神经康复住院时长。
从提交给英国康复结果协作组织的数据中提取社会人口统计学、医学和功能变量。住院时长以住院总天数计算，功能状态使用巴氏指数进行测量，康复复杂性使用扩展康复复杂性量表进行测量，护理依赖性使用诺思威克公园依赖性量表进行测量。
平均康复住院时长为70.9天，获得性脑损伤患者的住院时长比脊髓损伤患者长35.1天。诊断类别、入院时的巴氏指数评分、扩展康复复杂性量表评分和诺思威克公园依赖性量表评分可独立预测住院时长。纳入诊断组、巴氏指数、扩展康复复杂性量表和诺思威克公园依赖性量表的多元回归在统计学上显著预测了住院时长变异性的37.9%（p < 0.005）。入院时的诺思威克公园依赖性量表与住院患者住院时长的相关性最强。
总之，住院时长可通过诊断类别、扩展康复复杂性量表、诺思威克公园依赖性量表和巴氏指数进行预测。康复住院时长最具影响力的预测指标是入院时的诺思威克公园依赖性量表评分。这些结果可能有助于促进康复资源规划和有效委托计划的实施。对康复的启示住院神经康复住院时长最准确的预测变量是入院时诺思威克公园依赖性量表评分所衡量的护理需求。可以根据入院变量为服务使用者和委托方提供更现实的住院时长预测，这些预测可用于规划住院康复。年龄和性别似乎对康复总时长没有影响。
