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.

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Background and Purpose We aimed to identify reliable neuroradiological features of the brainstem reflecting the neurological symptoms of patients with chronic disorders of consciousness (DOCs) due to severe traumatic brain injury (TBI). Methods We retrospectively examined 86 patients with chronic DOCs due to severe TBI caused by automobile accidents. We studied the relationships among (1) neurological symptoms, including consciousness level, (2) integrated cognitive/physical condition, and (3) neuroradiological features of the brainstem (brainstem volume on MRI, fractional anisotropy [FA] value in the brainstem, and standardized uptake value [SUV] of 18F‐fluorodeoxyglucose [FDG] on positron emission tomography in the brainstem). Results Brainstem volume was significantly larger and FA values were significantly higher in patients with a better level of consciousness. However, brainstem volumes were significantly decreased and the maximum SUV (SUVmax) of FDG significantly increased at 2 years following admission regardless of the level of consciousness at admission. The brainstem volume was significantly larger and the FA value and SUVmax of FDG were significantly higher in patients with better National Agency for Automotive Safety and Victims’ Aid (NASVA) scores at admission. The decrease in the brainstem volume was significantly minimized and the SUVmax of FDG significantly increased in patients with more improvement in the NASVA score 2 years after admission. Conclusions The volume, FA value, and SUVmax of FDG of the brainstem are important neuroradiological features associated with the neurological conditions of patients with chronic DOCs due to severe TBI.

[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.