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一项基于登记的研究,比较了 2011 年和 2017 年急性卒中后计划康复的情况。

A register-based study comparing planned rehabilitation following acute stroke in 2011 and 2017.

机构信息

Institute of Neuroscience and Physiology, Rehabilitation Medicine, University of Gothenburg, Per Dubbsgatan 14, fl. 3, 413 45, Gothenburg, Sweden.

Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

Sci Rep. 2021 Nov 26;11(1):23001. doi: 10.1038/s41598-021-02337-5.

Abstract

This cross-sectional, register-based study aimed to explore patterns of planned rehabilitation at discharge from stroke units in Sweden in 2011 and 2017 and identify explanatory variables for planned rehabilitation. Multivariable binary logistic regression was used to identify variables that could explain planned rehabilitation. There were 19,158 patients in 2011 and 16,508 patients in 2017 with stroke, included in the study. In 2011, 57% of patients were planned for some form of rehabilitation at discharge from stroke unit, which increased to 72% in 2017 (p < 0.001). Patients with impaired consciousness at admission had increased odds for planned rehabilitation (hemorrhage 2011 OR 1.43, 95% CI 1.13-1.81, 2017 OR 1.66, 95% CI 1.20-2.32), (IS 2011 OR 1.21, 95% CI 1.08-1.34, 2017 OR 1.49, 95% CI 1.28-1.75). Admission to a community hospital (hemorrhage 2011 OR 0.56, 95% CI 0.43-0.74, 2017 OR 0.39, 95% CI 0.27-0.56) (IS 2011 OR 0.63, 95% CI 0.58-0.69, 2017 OR 0.54, 95% CI 0.49-0.61) or to a specialized non-university hospital (hemorrhage 2017 OR 0.66, 95% CI 0.46-0.94), (IS 2011 OR 0.90, 95% CI 0.82-0.98, 2017 OR 0.76, 95% CI 0.68-0.84) was associated with decreased odds of receiving planned rehabilitation compared to admission to a university hospital. As a conclusion severe stroke was associated with increased odds for planned rehabilitation and patients discharged from non-university hospitals had consistently decreased odds for planned rehabilitation.

摘要

本横断面、基于登记的研究旨在探讨 2011 年和 2017 年瑞典卒中单元出院时计划康复的模式,并确定计划康复的解释变量。多变量二项逻辑回归用于确定可解释计划康复的变量。共有 19158 名 2011 年和 16508 名 2017 年卒中患者纳入研究。2011 年,57%的患者在卒中单元出院时计划进行某种形式的康复,而 2017 年这一比例增加到 72%(p<0.001)。入院时意识障碍的患者计划康复的可能性增加(出血 2011 OR 1.43,95%CI 1.13-1.81,2017 OR 1.66,95%CI 1.20-2.32),(IS 2011 OR 1.21,95%CI 1.08-1.34,2017 OR 1.49,95%CI 1.28-1.75)。入住社区医院(出血 2011 OR 0.56,95%CI 0.43-0.74,2017 OR 0.39,95%CI 0.27-0.56)(IS 2011 OR 0.63,95%CI 0.58-0.69,2017 OR 0.54,95%CI 0.49-0.61))或专门的非大学医院(出血 2017 OR 0.66,95%CI 0.46-0.94)(IS 2011 OR 0.90,95%CI 0.82-0.98,2017 OR 0.76,95%CI 0.68-0.84))与接受计划康复的可能性降低相关,而入住大学医院则相反。总之,严重卒中与计划康复的可能性增加相关,而从非大学医院出院的患者计划康复的可能性持续降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0f2/8626515/3e3f77fdcc06/41598_2021_2337_Fig1_HTML.jpg

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