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卒中康复后患者住院时间的预测因素。

Predictors of patient length of stay post stroke rehabilitation.

机构信息

Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand.

出版信息

Afr Health Sci. 2023 Jun;23(2):543-552. doi: 10.4314/ahs.v23i2.63.

Abstract

BACKGROUND

There is little research on length of hospital stay (LOS) in patients post stroke in South African rehabilitation facilities. As LOS is an important indicator of cost-of-care, this information may be useful to all stakeholders.

OBJECTIVES

To determine the predictors of hospital LOS in patients post stroke rehabilitation.

METHODS

A retrospective file review of 243 patients.

RESULTS

Patient functional ability was measured using the Functional Independence Measure (FIM). Predictors of LOS were determined with multiple regression analysis. The median admission and discharge FIM scores were 43 (range: 16-119) and 75 (range: 16-120) points respectively. The median LOS was 43 (range: 3-112) days. Predictors of LOS were premorbid psychiatric conditions, impaired speech, requiring oxygen support, the development of pneumonia and admission FIM motor score, with admission FIM motor score being the strongest individual predictor of LOS (41%).

CONCLUSION

Admission FIM score had an influence on patient outcomes and LOS. Patients with higher admission FIM motor scores may be able to participate in rehabilitation better and thus have shorter LOS. Being able to predict LOS on admission allows facility administrators to manage bed occupancy, human and clinical resources in post stroke rehabilitation.

摘要

背景

在南非康复机构中,针对脑卒中患者的住院时间(LOS)的研究较少。由于 LOS 是医疗成本的一个重要指标,因此这些信息可能对所有利益相关者都有用。

目的

确定脑卒中康复患者 LOS 的预测因素。

方法

对 243 例患者进行回顾性病历审查。

结果

使用功能独立性量表(FIM)来衡量患者的功能能力。采用多元回归分析确定 LOS 的预测因素。入院和出院时的 FIM 中位数分别为 43(范围:16-119)和 75(范围:16-120)分。中位 LOS 为 43(范围:3-112)天。 LOS 的预测因素是发病前的精神状况、言语障碍、需要吸氧支持、肺炎的发生以及入院时的 FIM 运动评分,其中入院时的 FIM 运动评分是 LOS 的最强独立预测因素(41%)。

结论

入院时的 FIM 评分对患者的预后和 LOS 有影响。入院时 FIM 运动评分较高的患者可能能够更好地参与康复治疗,因此 LOS 较短。能够在入院时预测 LOS 有助于康复机构的管理人员管理脑卒中康复患者的床位占用情况、人力资源和临床资源。

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eNeurologicalSci. 2016 Jun 1;3:26-32. doi: 10.1016/j.ensci.2016.01.001.
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Predicting outcome after stroke: the role of aphasia.预测卒中后的结局:失语症的作用。
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