Wu Cheng-Che, Chen Ying-Hsun, Huang Hui-Chuan, Lin Kuan-Chia
Department of Physical Medicine and Rehabilitation, Sinwu Branch, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan.
J Res Med Sci. 2024 Oct 24;29:61. doi: 10.4103/jrms.jrms_62_23. eCollection 2024.
Few studies explore the patient heterogeneity, trajectory development, and factors influencing the functional recovery of the postacute care cerebrovascular disease (PAC-CVD) program. The objective of the study was to analyze the group-based trajectory and different functional improvement for patients with acute stroke participating in the PAC-CVD program.
A total of 328 patients with acute stroke who had participated in PAC-CVD program in rehabilitation departments of three hospitals from 2014 to 2017 were enrolled in this retrospective cohort study. Latent profile analysis (LPA) was applied to analyze the clinical characteristics between high- and low-function groups (LFGs). The analysis of variance and Chi-square test were used to analyze the association between functional grouping and patients' characteristics.
In the study baseline, patients could be divided into high function group (HFG; 85/328 = 25.9%), medium function group (MFG; 128/328 = 39.02%), and (LFG; 115/328 = 35.06%) by LPA. age ( = 0.001), length of hospital stays ( = 0.001), male sex ( = 0.048), and lesion type ( = 0.023) were significantly associated with being grouped in the high-function group. After 6 weeks of rehabilitation training, 100% of HFG remained as HFG, 49.04% of MFG transitioned to HFG, and 50% of MFG continued to remain as MFG. 8.41% of LFG transitioned to HFG, 57% of LFG transitioned to MFG, but still, 34.58% of LFG continued to remain as LFG.
Identifying initial functional groups can guide medical professionals to target patients for PAC service use. PAC-CVD high-intensity rehabilitation significantly enhances acute stroke patients' functional recovery, though effectiveness varies over time. These factors highlight the need for further development of rehabilitation programs to boost patient independence.
很少有研究探讨急性后期护理脑血管疾病(PAC-CVD)项目中患者的异质性、轨迹发展以及影响功能恢复的因素。本研究的目的是分析参与PAC-CVD项目的急性卒中患者基于组别的轨迹和不同的功能改善情况。
本回顾性队列研究纳入了2014年至2017年在三家医院康复科参加PAC-CVD项目的328例急性卒中患者。应用潜在类别分析(LPA)来分析高功能组和低功能组(LFGs)之间的临床特征。采用方差分析和卡方检验来分析功能分组与患者特征之间的关联。
在研究基线时,通过LPA可将患者分为高功能组(HFG;85/328 = 25.9%)、中功能组(MFG;128/328 = 39.02%)和低功能组(LFG;115/328 = 35.06%)。年龄(= 0.001)、住院时间(= 0.001)、男性(= 0.048)和病变类型(= 0.023)与被分入高功能组显著相关。经过6周的康复训练后,100%的HFG仍为HFG,49.04%的MFG转变为HFG,50%的MFG继续保持为MFG。8.41%的LFG转变为HFG,57%的LFG转变为MFG,但仍有34.58%的LFG继续保持为LFG。
识别初始功能组可以指导医疗专业人员针对PAC服务使用的目标患者。PAC-CVD高强度康复显著提高急性卒中患者的功能恢复,尽管效果随时间而异。这些因素凸显了进一步开发康复项目以提高患者独立性的必要性。