Western University,London, Ontario,Canada.
Public Health Agency of Canada,Ottawa,Canada.
Can J Neurol Sci. 2019 Mar;46(2):209-215. doi: 10.1017/cjn.2018.386. Epub 2019 Feb 11.
We reviewed numerous variables for ischemic stroke patients admitted to a rehabilitation unit to determine those that were statistically associated with discharge destination.
A retrospective chart review of patients with ischemic stroke discharged from the rehabilitation unit between January 1, 2005 and December 31, 2015. Variables were examined for their association with discharge destination (home versus long-term care (LTC)). Univariable relationships with discharge destination were assessed, and a multivariable logistic regression model was built.
Univariate predictors of discharge to LTC: advanced age, decreasing admission and discharge functional independence measure (FIM) scores, increasing change in FIM score from admission to discharge, dependency, residence outside of home before the stroke, absence of a caregiver, urinary and bowel incontinence, low Berg balance score at admission and discharge, low Montreal Cognitive Assessment scores, smoking, chronic heart failure, and an inability to transfer. Multivariable logistic regression: five factors remained significant predictors with LTC disposition: advanced age, bowel incontinence, residence outside of the home prior to stroke, right hemisphere site of the stroke, and absence of a caregiver.
Several easily measured variables were significantly associated with discharge to LTC versus home following stroke rehabilitation.
我们回顾了许多因缺血性脑卒中而入住康复病房的患者的变量,以确定与出院去向具有统计学关联的因素。
对 2005 年 1 月 1 日至 2015 年 12 月 31 日期间从康复病房出院的缺血性脑卒中患者进行回顾性图表审查。研究了各种变量与出院去向(家庭与长期护理(LTC))之间的关系。评估了与出院去向相关的单变量关系,并建立了多变量逻辑回归模型。
LTC 出院的单变量预测因素:年龄较大、入院和出院功能独立性测量(FIM)评分降低、FIM 评分从入院到出院的变化增加、依赖、脑卒中前居住在家庭以外、无照顾者、尿失禁和大便失禁、入院和出院时的 Berg 平衡评分低、蒙特利尔认知评估评分低、吸烟、慢性心力衰竭以及无法转移。多变量逻辑回归:有五个因素仍然是与 LTC 处置相关的重要预测因素:年龄较大、大便失禁、脑卒中前居住在家庭以外、右侧半球脑卒中部位以及无照顾者。
在脑卒中康复后,有几个易于测量的变量与 LTC 出院显著相关,而非家庭出院。