Matsubara Masanori, Sonoda Shigeru, Watanabe Makoto, Okuyama Yuko, Okazaki Hideto, Okamoto Sayaka, Mizuno Shiho
Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie, Japan.
Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie, Japan.
J Stroke Cerebrovasc Dis. 2021 Dec;30(12):106110. doi: 10.1016/j.jstrokecerebrovasdis.2021.106110. Epub 2021 Sep 26.
To examine the effect of onset to admission interval (OAI) and stroke type on activities of daily living (ADL) outcome.
Stroke patients (n=3112) admitted to and discharged from comprehensive inpatient rehabilitation wards at Nanakuri Memorial Hospital were classified into 8 OAI segments and by stroke type [intracerebral hemorrhage (ICH) and cerebral infarction (CI)]. Motor subscore of the Functional Independence Measure (FIM-M) on admission, FIM-M at discharge, FIM-M gain, length of stay (LOS), and FIM-M efficiency in the ICH and CI group matched by OAI segment were compared using the Wilcoxon test. Multiple comparisons using the Steel-Dwass test of FIM-M on admission, FIM-M at discharge, FIM-M gain, LOS, and FIM-M efficiency by OAI segments were performed.
FIM-M on admission was lower in the ICH group than the CI group in matched OAI segments. However, FIM-M improvement was greater in the ICH group than the CI group, resulting in no difference in FIM-M between groups at discharge. In both groups, the longer the OAI, the lower the FIM-M on admission and at discharge. The distribution pattern of significant differences among OAI segments differed between the groups. LOS tended to be longer and FIM-M efficiency tended to be higher in the ICH group than in the CI group.
The brain mass effect at the time of admission was larger and took longer to decrease in the ICH group than in the CI group. These results may improve prediction of outcomes in comprehensive inpatient rehabilitation wards.
探讨发病至入院间隔时间（OAI）及卒中类型对日常生活活动（ADL）结局的影响。
纳入那纳库里纪念医院综合住院康复病房收治并出院的卒中患者（n = 3112），根据OAI分为8个时间段，并按卒中类型[脑出血（ICH）和脑梗死（CI）]进行分类。采用Wilcoxon检验比较ICH组和CI组在各OAI时间段匹配后的入院时功能独立性测量运动分项评分（FIM-M）、出院时FIM-M、FIM-M增益、住院时间（LOS）及FIM-M效率。对各OAI时间段的入院时FIM-M、出院时FIM-M、FIM-M增益、LOS及FIM-M效率进行Steel-Dwass检验的多重比较。
在匹配的OAI时间段内，ICH组入院时的FIM-M低于CI组。然而，ICH组的FIM-M改善程度大于CI组，导致两组出院时FIM-M无差异。在两组中，OAI越长，入院时和出院时的FIM-M越低。两组间OAI各时间段的显著差异分布模式不同。ICH组的LOS往往更长，FIM-M效率往往高于CI组。
ICH组入院时的脑质量效应比CI组更大，且下降所需时间更长。这些结果可能有助于改善综合住院康复病房结局的预测。
