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运动评估量表对卒中后出院目的地的预测效度

Predictive Validity of Motor Assessment Scale on Poststroke Discharge Destination.

作者信息

Conradsen Irene, Henriksen Marius, Rytter Hana Malá

机构信息

Department of Physical and Occupational Therapy Copenhagen University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark.

Center for Rehabilitation of Brain Injury, Copenhagen, Denmark.

出版信息

Rehabil Res Pract. 2024 Jul 20;2024:2914252. doi: 10.1155/2024/2914252. eCollection 2024.

Abstract

Stroke frequently leads to hospital admission and subsequent rehabilitation in order to overcome poststroke sequelae, such as motor impairments. Efficient planning of the steps following hospital admission includes early prediction of whether the patient can be discharged home or not. Early assessment of motor performance in patients with stroke-induced motor deficits may be able to function as a predictor of discharge destination but is less explored. The primary objective was to assess the predictive validity of the Motor Assessment Scale (MAS) on discharge destination both regarding total score and regarding subscores (transfer-mobility items and upper extremity items). The study was designed as a prospective cohort study. Thirty-seven consecutively recruited patients with stroke are the subjects of the study. Logistic regression model was used to calculate the odds of being discharged to own home upon hospital admittance. The predictive ability was examined with a receiving operator characteristic (ROC) curve, and cut-points from the curve were employed in Cox regression. A one-unit higher score on the total MAS significantly increased the odds of being discharged home upon hospital admittance (odds ratio (OR) 1.14, 95% CI 1.04-1.25). The same pattern was observed with the summed items of 1-5 and 6-8. The total MAS showed sensitivity of 91.7% and specificity of 68.0%. Patients having a total MAS score ≥ 24 were 17 times more likely to be discharged home (HR 17.64, 95% CI 2.23-139.57) compared to patients with a lower score. Motor function measured by the MAS can be applied as a predictor of discharge destination upon hospital admission after stroke in Danish setting.

摘要

中风常常导致患者住院并随后接受康复治疗,以克服中风后遗症,如运动障碍。住院后高效的步骤规划包括早期预测患者是否能够出院回家。对中风导致运动功能缺损患者的运动表现进行早期评估可能能够作为出院目的地的预测指标,但这方面的研究较少。主要目的是评估运动评估量表(MAS)在出院目的地方面的预测效度,包括总分以及子分数(转移-移动项目和上肢项目)。该研究设计为前瞻性队列研究。37名连续招募的中风患者是研究对象。使用逻辑回归模型计算入院时出院回家的几率。通过接受者操作特征(ROC)曲线检验预测能力,并将曲线上的切点用于Cox回归。MAS总分每高一个单位,入院时出院回家的几率显著增加(优势比(OR)1.14,95%置信区间1.04-1.25)。1-5项和6-8项的总和也观察到相同模式。MAS总分的敏感性为91.7%,特异性为68.0%。与得分较低的患者相比,MAS总分≥24分的患者出院回家的可能性高17倍(风险比17.64,95%置信区间2.23-139.57)。在丹麦的情况下,MAS测量的运动功能可作为中风后入院时出院目的地的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7228/11283334/e40b053e4f49/RERP2024-2914252.001.jpg

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