A multicenter study to compare the effectiveness of the inpatient post acute care program versus traditional rehabilitation for stroke survivors

Chang, Ke‐Vin; Chen, Kaihua; Chen, Ying-Hsun; Lien, Wei‐Chih; Chang, Wei-Han; Lai, Chung-Liang; Wu, Cheng-Che; Chen, Chia-Hsin; Chen, Yu‐Hsin; Wu, Wei‐Ting; Wang, Tyng-Guey; Han, Der‐Sheng

doi:10.1038/s41598-022-16984-9

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…The PAC-CVD program is considered a more economical and favorable recovery strategy than traditional rehabilitation [12,33]. Chen et al recently reported that within the first year after stroke rehabilitation, the NHI cost was higher in the non-PAC group (USD 3785 per person) than in the PAC group (USD 3480 per person) [13].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Cost over 12 Hospitalization Weeks of Postacute Care for Stroke

Chou

et al. 2023

IJERPH

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Few studies have investigated changes in functional outcomes and economic burden in patients in the postacute care cerebrovascular disease (PAC-CVD) program. We, for the first time, retrospectively investigated changes in functional performance and the national health insurance (NHI) cost over 12 PAC-CVD hospitalization weeks and evaluated the therapeutic effects of the PAC-CVD program on the NHI cost. Specifically, the functional outcomes and NHI cost of 263 stroke patients in the PAC-CVD program were analyzed. The repeated measures t test was used to compare functional performance over 0–3 weeks, and a one-way repeated measures multivariate analysis of variance was used to compare functional performance and NHI costs during weeks 0–6 and 0–9. The Wilcoxon signed-rank test was used to compare functional performance over weeks 9–12. Hierarchical multiple regression was used to estimate the effects of functional performance on NHI costs during weeks 3, 6, and 9. Over weeks 0–12, all functional performance measures demonstrated significant improvements. Changes in NHI costs varied depending on whether hospitalization was extended. At any time point, functional performance did not have a significant impact on NHI cost. Therefore, the PAC-CVD program may aid patients with stroke in sustainably regaining functional performance and effectively controlling economic burden.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Cost over 12 Hospitalization Weeks of Postacute Care for Stroke

Chou

et al. 2023

IJERPH

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“…The studies that applied the MNA-SF to stroke patients were all carried out in Far Eastern Countries, apart from one from Italy [ 18 , 34 , 35 , 49 , 50 , 51 , 52 , 62 , 63 ], as shown in Table 1 . In most studies, patients (suffering from AIS or AHS) were recruited by rehabilitation facilities.…”

Section: Nutritional Screening Toolsmentioning

confidence: 99%

“…Upon admission, the MNA-SF score is significantly related to cognitive impairment ( Table 2 ) and independence in ADL [ 35 , 49 , 51 , 52 ], but not quality of life [ 35 ]. The MNA-SF showed better improvement when energy intake upon admission was higher [ 52 ], and when a post-acute care program was compared to a traditional inpatient rehabilitation approach [ 18 ]. As for clinical outcomes, in a rehabilitation setting, the MNA-SF has been associated with functional independence at discharge but not with the discharge destination [ 50 , 51 ].…”

Section: Nutritional Screening Toolsmentioning

confidence: 99%

The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients

et al. 2023

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Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to be rapid, simple, cost-effective, and reliable in the clinical setting. This review focuses on the tools/procedures used in stroke patients to assess nutritional risk, with a particular focus on their relationships with patients’ clinical characteristics and outcomes. Different screening tools/procedures have been used in stroke patients, which have shown varying prevalence in terms of nutritional risk (higher in rehabilitation units) and significant relationships with clinical outcomes in the short- and long term, such as infection, disability, and mortality. Indeed, there have been few attempts to compare the usefulness and reliability of the different tools/procedures. More evidence is needed to identify appropriate approaches to assessing nutritional risk among stroke patients in the acute and sub-acute phase of disease or during rehabilitation; to evaluate the impact of nutritional treatment on the risk of malnutrition during hospital stay or rehabilitation unit; and to include nutritional screening in well-defined nutritional care protocols.

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“…13 In a multicenter study, an intensive rehabilitation program initiated within the first month after stroke resulted in greater improvement in ADL, nutrition, cognition, and shorter LOS than a traditional program initiated later. 14 It is widely known that recovery is relatively quick in the first month following a stroke and then slows down 3 to 6 months later. 15 Hence, the first month, which is considered as a window of opportunity, should be included in the rehabilitation pe-riod.…”

Section: Discussionmentioning

confidence: 99%

Real-Life Experiences in Subacute Neurological Rehabilitation: Predictors of Functional Outcomes

ATA,

ALEMDAROĞLU,

KARAMEHMETOĞLU

et al. 2024

J PMR Sci

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The aim of this study is to examine the clinical features of patients hospitalized at the subacute neurological rehabilitation unit, to compare the patients who participated in rehabilitation program in the early and late period of the disease and to define the independent determinants that affect the rehabilitation outcome. Material and Methods: In this retrospective study, all patients in the subacute neurological rehabilitation clinic were reviewed. The medical records of 230 patients were examined retrospectively. Patients were categorized into two groups as early (≤1 month) and late (1-12 months) according to the time between the onset of the event and admission to the rehabilitation unit. Results: A total of 191 patients were included in the study. At the time of admission, percutaneous endoscopic gastrostomy (p=0.001) and tracheostomy (p=0.014) were more common in the late group. Although, all patients benefited from the rehabilitation program, the benefit in terms of Functional Ambulation Classification (FAC) and Brunnstom Motor Recovery Stage, lower extremity was higher in the early group (p=0.030 and p=0.028, respectively). The male gender [odds ratio (OR)=1.85] and being in the early rehabilitation group (OR=1.83) were positive predictors, the presence of contracture (OR=0.28), pressure injury (OR=0.37), respiratory problems (OR=0.23), and sleep problems (OR=0.37) were negative predictors for improvement of FAC. Conclusion: The findings of this study indicate that neurological rehabilitation is effective for functional outcomes and that male gender and participation in the early rehabilitation group were independent predictors of increased ambulation.

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A multicenter study to compare the effectiveness of the inpatient post acute care program versus traditional rehabilitation for stroke survivors

Cited by 5 publications

References 24 publications

Efficacy and Cost over 12 Hospitalization Weeks of Postacute Care for Stroke

Efficacy and Cost over 12 Hospitalization Weeks of Postacute Care for Stroke

The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients

Real-Life Experiences in Subacute Neurological Rehabilitation: Predictors of Functional Outcomes

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