Sato Atsushi, Fujita Takaaki, Yamamoto Yuichi
Department of Physical Therapy, Yachiyo Rehabilitation College.
Tohoku Fukushi University.
Phys Ther Res. 2017 Jul 28;20(2):23-27. doi: 10.1298/ptr.E9914. eCollection 2017.
This study aimed to calculate cut-off values of activities of daily living independence level for stroke patient home discharge based on the number of family caregivers. The subjects comprised 1442 stroke patients (26 hospitals) who were registered of the Japanese Rehabilitation Database. Receiver operating characteristic curves were used to elucidate the BI and FIM instrument scores necessary for home discharge. Analysis was performed for each subject according to the number of family caregivers, i.e., no caregiver, one person, two persons or more, and overall. The BI cut-off points that discriminated between home discharge and other were 65/60 points overall, 75/70 points in patients with no caregiver, 65/60 points in patients with one caregiver, and 60/55 points in patients with two or more caregivers. The FIM instrument cut-off points were 90/89 points overall, 101/100 points in patients with no caregiver, 87/86 points in patients with one caregiver, and 87/86 points in patients with two or more caregivers. Our results indicated that home discharge for patients with many caregivers was possible even with low ADL independence levels, and that there was a large difference in cut-off values depending on the presence or absence of one caregiver.
本研究旨在根据家庭照顾者的数量计算脑卒中患者居家出院时日常生活独立水平的临界值。研究对象包括日本康复数据库登记的1442例脑卒中患者（来自26家医院）。采用受试者工作特征曲线来阐明居家出院所需的巴氏指数（BI）和功能独立性评定量表（FIM）得分。根据家庭照顾者的数量，即无照顾者、1人、2人及以上，以及总体情况，对每个受试者进行分析。区分居家出院和其他情况的BI临界值总体为65/60分，无照顾者的患者为75/70分，有1名照顾者的患者为65/60分，有2名及以上照顾者的患者为60/55分。FIM评定量表的临界值总体为90/89分，无照顾者的患者为101/100分，有1名照顾者的患者为87/86分，有2名及以上照顾者的患者为87/86分。我们的结果表明，即使日常生活活动独立性水平较低，有多名照顾者的患者也有可能居家出院，并且根据是否有1名照顾者，临界值存在很大差异。
