Lu Kuan-Hsien, Lin Huey-Juan, Ho Chung-Han, Lin Kuan-Hung
Department of Neurology, Chi Mei Medical Center, Tainan, Taiwan, Republic of China.
Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan, Republic of China.
Int J Gen Med. 2024 Oct 30;17:5029-5037. doi: 10.2147/IJGM.S475981. eCollection 2024.
Acute stroke significantly increases the risk of long-term care facility (LTCF) admission, due to sudden functional impairments. This study aims to identify risk factors associated with LTCF admission among stroke patients, specifically targeting those who transitioned from independence to disability after stroke.
We retrospectively enrolled 2027 stroke patients admitted between 2017 and 2022 from the Chi Mei Medical Center's stroke registry in Southern Taiwan, focusing on those with pre-stroke modified Rankin Scale (mRS) scores ≤ 2 and post-stroke mRS scores ≥ 3. Patients were categorized into LTCF and non-LTCF groups. Stroke severity, comorbidities, and discharge outcomes were evaluated, using logistic regression analyses to identify LTCF admission risk factors.
Of the 2027 patients, 343 (16.9%) were admitted to LTCFs post-discharge. The LTCF group exhibited higher discharge mRS and National Institute of Health Stroke Scale scores, and lower Barthel Index scores. Factors linked to LTCF admission included higher discharge mRS scores, lower Barthel Index scores, nasogastric tube placement at discharge, and longer hospital stays. Barthel Index scores showed no significant change from admission to discharge in the LTCF group.
Stroke severity, post-stroke functional status and nasogastric tube placement are significant predictors of LTCF admission in stroke patients. Early recognition of these factors is crucial for effective discharge planning and reducing the need for institutionalization. The study emphasizes the need for personalized interventions targeting these risk factors to improve patient outcomes and optimize medical resource utilization.
急性中风会因突然出现的功能障碍而显著增加入住长期护理机构（LTCF）的风险。本研究旨在确定中风患者中与入住LTCF相关的风险因素，特别针对那些中风后从独立状态转变为残疾状态的患者。
我们回顾性纳入了2017年至2022年间从台湾南部奇美医学中心中风登记处收治的2027例中风患者，重点关注中风前改良Rankin量表（mRS）评分≤2且中风后mRS评分≥3的患者。将患者分为LTCF组和非LTCF组。评估中风严重程度、合并症和出院结局，采用逻辑回归分析确定入住LTCF的风险因素。
2027例患者中，343例（16.9%）出院后入住LTCF。LTCF组出院时的mRS和美国国立卫生研究院中风量表评分较高，Barthel指数评分较低。与入住LTCF相关的因素包括出院时mRS评分较高、Barthel指数评分较低、出院时放置鼻胃管以及住院时间较长。LTCF组从入院到出院的Barthel指数评分无显著变化。
中风严重程度、中风后功能状态和鼻胃管放置是中风患者入住LTCF的重要预测因素。早期识别这些因素对于有效的出院计划和减少机构化需求至关重要。该研究强调需要针对这些风险因素进行个性化干预，以改善患者结局并优化医疗资源利用。
