Nakaizumi Dai, Uchiyama Keita, Washida Kei, Miyata Shingo
Department of Physical Therapy, Graduate Course of Rehabilitation Science, Division of Health Sciences, College of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, JPN.
Department of Rehabilitation, Japanese Red Cross Kanazawa Hospital, Kanazawa, JPN.
Cureus. 2024 Nov 19;16(11):e73982. doi: 10.7759/cureus.73982. eCollection 2024 Nov.
Objectives Home discharge is a crucial goal for stroke patients in convalescent rehabilitation wards. While previous studies have identified relationships between Functional Independence Measure (FIM) scores and home discharge outcomes using conventional statistical methods, these analyses have limitations in visualizing combinations of independent FIM items. This study aimed to identify combinations of independent motor FIM items associated with home discharge in stroke patients using UpSet plots. Methods We analyzed 205 stroke patients admitted to a convalescent rehabilitation ward between April 2018 and March 2021. Independence in motor FIM items was defined as a score of 6 or higher. We used UpSet plots to visualize combinations of independent motor FIM items at discharge and identified major combinations (occurring in >7% of cases) in the home discharge group. Results Among 136 patients discharged to home, four major combinations of independent motor FIM items were identified: independence in all 13 items (22 patients, or 16.2%), independence in 12 items excluding stairs (18 patients, or 13.2%), independence in 10 items excluding bathing, tub transfer, and stairs (14 patients, or 10.3%), and dependence in all items (11 patients, or 8.1%). These combinations accounted for 47.8% of home discharge cases. Conclusions The visual analysis using UpSet plots revealed that, while higher levels of activities of daily living (ADL) independence increased the likelihood of home discharge, complete independence was not required. Dependence on specific items, such as bathing, tub transfer, and stairs, could be compensated through care services and environmental modifications. These findings provide practical insights for developing rehabilitation strategies and discharge planning.
目的 家庭出院是康复病房中中风患者的一个关键目标。虽然先前的研究使用传统统计方法确定了功能独立性测量（FIM）评分与家庭出院结果之间的关系，但这些分析在可视化独立FIM项目的组合方面存在局限性。本研究旨在使用UpSet图确定中风患者中与家庭出院相关的独立运动FIM项目的组合。方法 我们分析了2018年4月至2021年3月期间入住康复病房的205例中风患者。运动FIM项目的独立性定义为得分6分或更高。我们使用UpSet图来可视化出院时独立运动FIM项目的组合，并确定家庭出院组中的主要组合（发生率>7%）。结果 在136例出院回家的患者中，确定了独立运动FIM项目的四种主要组合：所有13项均独立（22例患者，占16.2%）；除楼梯外12项独立（18例患者，占13.2%）；除洗澡、浴缸转移和楼梯外10项独立（14例患者，占10.3%）；所有项目均依赖（11例患者，占8.1%）。这些组合占家庭出院病例的47.8%。结论 使用UpSet图进行的可视化分析表明，虽然更高水平的日常生活活动（ADL）独立性增加了家庭出院的可能性，但并不需要完全独立。对特定项目的依赖，如洗澡、浴缸转移和楼梯，可以通过护理服务和环境改造来弥补。这些发现为制定康复策略和出院计划提供了实际见解。
