病前日常生活工具性活动可预测中风后的出院回家情况。
Premorbid instrumental activities of daily living predicts discharge home following stroke.
作者信息
Satow Takeshi, Komuro Taro, Ogawa Masafumi
机构信息
Department of Neurosurgery, Nagahama City Hospital, 313 Oinui-cho, Nagahama City, Shiga 526-8580, Japan.
Department of Neurology, Nagahama City Hospital, 313 Oinui-cho, Nagahama City, Shiga 526-8580, Japan.
出版信息
eNeurologicalSci. 2020 Jan 31;18:100226. doi: 10.1016/j.ensci.2020.100226. eCollection 2020 Mar.
BACKGROUND AND PURPOSE
Stroke survivors who remain dependent require multiple healthcare resources, including rehabilitation and nursing care. The effect of premorbid instrumental ADL (IADL) on the discharge destination, which has not been studied previously in detail, is analyzed.
MATERIALS AND METHODS
Between April and September 2015, 40 stroke patients admitted to hospital were enrolled prospectively in the present study. The ADL (Barthel index) and IADL (Frenchay activities index: FAI) scores in their premorbid status were recorded. Baseline demographic data, stroke severity (NIHSS) and type of stroke, and whether they lived with family were also recorded. Simple univariate regression was performed between the two discharge destination groups (Home or Not Home). Significant factors were then included in multivariate logistic regression in order to determine the adjusted odds ratio for the discharge destination. A value <.05 was taken as significant.
RESULTS
25 patients (64.1%) returned home. According to univariate analysis, NIHSS on admission and premorbid FAI were significantly associated with the discharge destination. Multivariate analysis found that NIHSS (OR, 0.71; 95% CI0.56-0.92; = .008) and premorbid FAI (OR, 1.17; 95% CI1.03-1.33; = .01) were independent predictors of the discharge destination.
CONCLUSIONS
Severity of stroke upon admission and premorbid IADL are associated with discharge destination following stroke.
背景与目的
仍有依赖的卒中幸存者需要多种医疗资源，包括康复和护理。分析病前工具性日常生活活动能力（IADL）对出院目的地的影响，此前尚未对此进行过详细研究。
材料与方法
2015年4月至9月期间，前瞻性纳入40例入院的卒中患者进行本研究。记录其病前状态下的日常生活活动能力（Barthel指数）和工具性日常生活活动能力（Frenchay活动指数：FAI）评分。还记录了基线人口统计学数据、卒中严重程度（美国国立卫生研究院卒中量表）和卒中类型，以及他们是否与家人同住。在两个出院目的地组（回家或未回家）之间进行简单单因素回归分析。然后将显著因素纳入多因素逻辑回归分析，以确定出院目的地的调整优势比。P值<0.05被视为具有显著性。
结果
25例患者（64.1%）回家。单因素分析显示，入院时的美国国立卫生研究院卒中量表评分和病前FAI与出院目的地显著相关。多因素分析发现，美国国立卫生研究院卒中量表评分（OR，0.71；95%CI 0.56 - 0.92；P = 0.008）和病前FAI（OR，1.17；95%CI 1.03 - 1.33；P = 0.01）是出院目的地的独立预测因素。
结论
入院时的卒中严重程度和病前IADL与卒中后的出院目的地相关。
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