Lehmann J F, DeLateur B J, Fowler R S, Warren C G, Arnhold R, Schertzer G, Hurka R, Whitmore J J, Masock A J, Chambers K H
Arch Phys Med Rehabil. 1975 Sep;56(9):383-9.
Predictors of functional outcome were developed in a group of 114 stroke patients consecutively admitted to a tertiary rehabilitation center. These predictors included a pool of medical data, the age of the patient, psychological tests and the patient's educational level. None of these predictor items showed a correlation with outcome high enough to allow precise prediction of individual outcome. They did, however, provide general indicators for those patients with severe functional impairment who are more likely to gain from a rehabilitation program. The group of medical predictors indicated that a patient with a more extensive, severe lesion, with signs of congestive heart failure, generalized arteriosclerosis, gross perceptual deficit, a lower level of education, and who is older, is less likely to improve in the rehabilitation program. Since a prediction on an individual basis was not possible, it was concluded that even the most severely involved patient should be provided with a therapeutic rehabilitation trial. There was no correlation between severity of the functional impairment at admission and the gains obtained in the rehabilitation program. The same predictors were used to predict whether the patient went home or to an institution. It was found that family income and involvement in support of the patient predicted this outcome, whereas medical data did not. Since family involvement can sometimes be changed by a therapeutic team, this predictor may also present a major target for therapeutic intervention.
在一家三级康复中心连续收治的114名中风患者中，研究了功能预后的预测因素。这些预测因素包括一系列医学数据、患者年龄、心理测试以及患者的教育水平。这些预测因素中没有一项与预后的相关性高到足以精确预测个体预后。然而，它们确实为那些功能严重受损、更有可能从康复计划中获益的患者提供了一般指标。医学预测因素表明，病变范围更广、更严重，伴有充血性心力衰竭、全身性动脉硬化、严重感知缺陷、教育水平较低且年龄较大的患者，在康复计划中改善的可能性较小。由于无法对个体进行预测，因此得出结论，即使是病情最严重的患者也应接受治疗性康复试验。入院时功能障碍的严重程度与康复计划中获得的改善之间没有相关性。同样的预测因素被用来预测患者是回家还是去机构。研究发现，家庭收入和对患者的支持程度可以预测这一结果，而医学数据则不能。由于治疗团队有时可以改变家庭的参与情况，因此这个预测因素也可能成为治疗干预的主要目标。
