Ahmed Subhan, Liu Evan, Nanavati Hely D, Lin Chen
University of Alabama at Birmingham, Birmingham, United States.
Birmingham VA Medical Center, Birmingham, United States.
Brain Disord. 2024 Jun;14. doi: 10.1016/j.dscb.2024.100133.
No consensus exists on the ideal duration of rehabilitation in patients with intracerebral hemorrhage (ICH). The aim of this study is to identify demographic and clinical characteristics associated with rehabilitation duration (RD) in patients with ICH during hospitalization.
This retrospective study followed consecutive patients admitted to a tertiary care center between 2016 and 2019 with primary diagnosis of ICH. The primary outcome, RD was calculated by adding the total number of therapy (speech, occupational, and physical) minutes received during admission, divided by the hospital length of stay. Variables abstracted included demographic and clinical characteristics (ICH score, neurosurgical procedure). Multiple linear regression models were used to measure adjusted association between select predictors and mean RD.
A total of 316 ICH patients (62.5 ± 15.9 years, 49 % White) were included in the final analysis. Compared to Whites, other racial minorities (β= -9.017, = 0.002) received rehabilitation therapy for a significantly shorter duration in the adjusted model. Age was significantly associated with having higher RD (β=0.320, < 0.001). Patients with lobar ICH (β= -7.486, = 0.014) had significantly shorter RD compared to deep. ICH score was significantly associated with having a lower RD (β= -8.624, < 0.001).
Age, race, ICH score, and location were significantly associated with RD. Non-White patients had significantly shorter RD, indicating a potential racial disparity in the rehabilitation of patients with ICH.
脑出血（ICH）患者的理想康复时长尚无共识。本研究旨在确定脑出血患者住院期间与康复时长（RD）相关的人口统计学和临床特征。
本回顾性研究纳入了2016年至2019年间入住三级医疗中心、初步诊断为脑出血的连续患者。主要结局指标RD的计算方法为，将入院期间接受的治疗（言语、职业和物理治疗）总分钟数相加，再除以住院时长。提取的变量包括人口统计学和临床特征（ICH评分、神经外科手术）。使用多元线性回归模型来衡量选定预测因素与平均RD之间的校正关联。
最终分析纳入了316例脑出血患者（62.5±15.9岁，49%为白人）。在校正模型中，与白人相比，其他少数族裔接受康复治疗的时长显著更短（β = -9.017，P = 0.002）。年龄与较高的RD显著相关（β = 0.320，P < 0.001）。与深部脑出血患者相比，脑叶脑出血患者的RD显著更短（β = -7.486，P = 0.014）。ICH评分与较低的RD显著相关（β = -8.624，P < 0.001）。
年龄、种族、ICH评分和出血部位与RD显著相关。非白人患者的RD显著更短，表明脑出血患者康复过程中可能存在种族差异。
