Sun Jin-Ju, Deng Yong-Mei, Wang Dan-Dan, Gu Hong-Qiu, Zhou Qi, Wang Yong-Jun, Li Zi-Xiao, Zhao Xing-Quan
Nursing Department, Beijing TianTan Hospital, Capital Medical University, Beijing, Fengtai, China.
Vascular Neurology, Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, Fengtai, China.
Neurol Res. 2023 Feb;45(2):103-111. doi: 10.1080/01616412.2022.2123174. Epub 2022 Sep 20.
Evidence shows that rehabilitation is the most effective strategy to reduce the disability rate of patients with stroke. However, there is limited understanding about the factors associated with rehabilitation assessment among patients with intracerebral hemorrhage (ICH) in China. We aimed to investigate the factors associated with rehabilitation assessment in patients with ICH and the relationship between rehabilitation assessment and hospitalization outcomes.
Data from 85,664 patients with ICH admitted to 1,312 hospitals between 1 August 2015 and 31 July 2019 were analyzed. A multivariable logistic regression model accounting for in-hospital clustering was used to identify patient and hospital factors associated with rehabilitation assessment during acute hospitalization.
A total of 62,228 (72.6%) patients with ICH underwent rehabilitation assessments. In multivariable analyses, factors associated with an increased likelihood of undergoing a rehabilitation assessment (P < .05) included a higher Glasgow Coma Scale score on admission, a history of hypertension, a history of peripheral vascular disease, dysphagia screening, carotid vessel imaging, and a longer length of hospital stay. Conversely, patients admitted to the intensive care unit and tertiary-grade hospitals were less likely to undergo rehabilitation assessments during hospitalization for ICH.
This study showed that the rate of rehabilitation assessment was 74.2%, which is low. Rehabilitation assessment was associated with longer hospital stays and lower mortality. Therefore, patients with acute cerebral haemorrhage should undergo comprehensive and professional rehabilitation assessment.
有证据表明，康复治疗是降低中风患者残疾率的最有效策略。然而，在中国，对于脑出血（ICH）患者康复评估相关因素的了解有限。我们旨在调查脑出血患者康复评估的相关因素以及康复评估与住院结局之间的关系。
分析了2015年8月1日至2019年7月31日期间在1312家医院收治的85664例脑出血患者的数据。采用考虑院内聚类的多变量逻辑回归模型来确定急性住院期间与康复评估相关的患者和医院因素。
共有62228例（72.6%）脑出血患者接受了康复评估。在多变量分析中，与接受康复评估可能性增加相关（P < 0.05）的因素包括入院时较高的格拉斯哥昏迷量表评分、高血压病史、外周血管疾病史、吞咽困难筛查、颈动脉血管成像以及较长的住院时间。相反，入住重症监护病房和三级医院的患者在脑出血住院期间接受康复评估的可能性较小。
本研究表明，康复评估率为74.2%，较低。康复评估与较长的住院时间和较低的死亡率相关。因此，急性脑出血患者应接受全面、专业的康复评估。
