Furuta Hiroaki, Mizuno Katsuhiro, Unai Kei, Ebata Hiroki, Yamauchi Keita, Watanabe Michiko
Department of Rehabilitation Therapy, Saiseikai Higashikanagawa Rehabilitation Hospital, Yokohama, Japan.
Department of Rehabilitation Therapy, Saiseikai Kanagawaken Hospital, Yokohama, Japan.
Prog Rehabil Med. 2022 Apr 23;7:20220021. doi: 10.2490/prm.20220021. eCollection 2022.
Using Functional Independence Measure (FIM) records, this study used latent class analysis (LCA) to clarify the structure of activities of daily living (ADL) status in patients following stroke.
In this retrospective, single-center study, we extracted the medical records of patients with stroke who were admitted to a rehabilitation hospital in Japan between April 2018 and March 2020. LCA was used to determine classes of ADL status based on response patterns in FIM items converted from the original seven levels to three levels: Complete Dependence, FIM1-2; Modified Dependence, FIM3-5; Independence, FIM6-7. We compared the length of stay and discharge destinations among subgroups of patients with different ADL status at admission.
From 373 patients, 1592 FIM records were analyzed. These were classified into six ADL status classes based on "Complete Dependence," "Modified Dependence," and "Independence" in the motor and cognitive domains. Significant differences were observed among the six admission ADL subgroups for the length of stay (median values in patient subgroups based on admission ADL status: 126, 146, 90, 65, 44, and 29 days in the Motor Complete/Cognitive Complete, Motor Complete/Cognitive Modified, Motor Modified/Cognitive Modified, Motor Modified/Cognitive Independent, Motor Independent/Cognitive Modified, and Motor Independent/Cognitive Independent groups, respectively) and discharge destinations (patients discharged home: 27%, 62%, 81%, 92%, 95%, and 98%, respectively, and to acute care hospitals: 18%, 14%, 8%, 8%, 2%, and 2%, respectively).
LCA successfully stratified ADL status in patients with stroke undergoing rehabilitation and may aid in determining an appropriate treatment regimen.
本研究利用功能独立性测量（FIM）记录，采用潜在类别分析（LCA）来阐明中风患者日常生活活动（ADL）状态的结构。
在这项回顾性单中心研究中，我们提取了2018年4月至2020年3月期间在日本一家康复医院住院的中风患者的病历。基于从原来的七个等级转换为三个等级的FIM项目的反应模式，使用LCA来确定ADL状态类别：完全依赖，FIM1 - 2；部分依赖，FIM3 - 5；独立，FIM6 - 7。我们比较了入院时具有不同ADL状态的患者亚组之间的住院时间和出院去向。
对373例患者的1592份FIM记录进行了分析。根据运动和认知领域的“完全依赖”、“部分依赖”和“独立”，这些记录被分为六个ADL状态类别。六个入院ADL亚组在住院时间（基于入院ADL状态的患者亚组中位数：运动完全/认知完全组、运动完全/认知部分依赖组、运动部分依赖/认知部分依赖组、运动部分依赖/认知独立组、运动独立/认知部分依赖组和运动独立/认知独立组分别为126天、146天、90天、65天、44天和29天）和出院去向（出院回家的患者分别为27%、62%、81%、92%、95%和98%，出院到急症医院的患者分别为18%、14%、8%、8%、2%和2%）方面存在显著差异。
LCA成功地对正在接受康复治疗的中风患者的ADL状态进行了分层，并可能有助于确定合适的治疗方案。
