To clarify the factors inhibiting home return of stroke patients living alone. [Participants and Methods] The subjects were 97 stroke patients who were living alone. We conducted hierarchical cluster analysis with variables of outcome, admission Functional Independence Measure (FIM), age, and inpatient days in order to identify groups having difficulty adjusting to discharge, and made comparisons among the groups. We conducted a text mining analysis after investigating the causes of difficulty in adjusting to discharge using a free-form questionnaire addressed to the relevant staff. [Results] The results of the cluster analysis were classified into 4 groups, and the results of text mining analysis were divided into 7 groups. [Conclusion] The results suggest that the factors inhibiting home return of stroke patients living alone were: higher brain dysfunction, motor paralysis, ADL ability, human resources such as family and supporters, financial problems, care insurance adjustment, and disparity between patient hope and reality.

Introduction: Protein energy wasting (PEW) is the most important risk factor for morbidity and mortality in hemodialysis patients. Inadequate dietary protein intake is a frequent cause of PEW. Recent studies have identified fibroblast growth factor 21 (FGF21) as an endocrine protein sensor. This study aims to investigate the potential of FGF21 as a biomarker for protein intake and PEW and to investigate intradialytic FGF21 changes. Methods: Plasma FGF21 was measured using an enzyme-linked immunoassay. Complete intradialytic dialysate and interdialytic urinary collections were used to calculate 24-h urea excretion and protein intake. Muscle mass was assessed using the creatinine excretion rate and fatigue was assessed using the Short Form 36 and the Checklist Individual Strength. Results: Out of 59 hemodialysis patients (65 ± 15 years, 63% male), 39 patients had a low protein intake, defined as a protein intake less than 0.9 g/kg/24-h. Patients with a low protein intake had nearly twofold higher plasma FGF21 compared to those with an adequate protein intake (FGF21 1370 [795e4034] pg/mL versus 709 [405e1077] pg/mL;P < 0.001). Higher plasma FGF21 was associated with higher odds of low protein intake (Odds Ratio: 3.18 [1.62e7.95] per doubling of FGF21; P ¼ 0.004), independent of potential confounders. Higher plasma FGF21 was also associated with lower muscle mass

[Purpose] To identify factors that affect the return to solitary living of patients with stroke who had lived alone prior to stroke onset. [Participants and Methods] From January 2017 to March 2020, we enrolled a total of 103 patients with stroke who had lived alone prior to stroke onset and retrospectively analyzed their age, gender, length of hospital stay, outcome (return to living alone or not), functional independence measure at discharge, and social score at discharge. We also analyzed the relationship between the above factors and the outcome. [Results] Functional independence measure and social score at discharge were significantly associated with the outcome. The cutoff value of the functional independence measure at discharge was 91 (area under the curve: 0.91; sensitivity: 0.96; specificity: 0.72), while the rate of return to living alone was 23.5% when the social score was ≥3. The sensitivity and specificity for return to living alone were 0.91 and 0.88, respectively, when cutoff values of the functional independence measure and social score at discharge were 91 and 3, respectively. [Conclusion] Social factors and ability to perform activities of daily living are important for return to solitary living for patients with stroke who lived alone prior to stroke onset.