Prognostic Factors of Activity Limitation and Discharge Destination after Stroke Rehabilitation

Massucci, Maurizio; Perdon, Luigi; Agosti, Maurizio; Celani, Maria Grazia; Righetti, Enrico; Recupero, Egidio; Todeschini, E.; Franceschini, Marco

doi:10.1097/01.phm.0000242620.44924.1b

Cited by 56 publications

(65 citation statements)

References 33 publications

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“…Knowledge of factors that help predict discharge destination have been established for the sub-acute setting. 5,6 Identification of such predictive factors in TCP would provide useful information for healthcare practitioners and health managers providing and planning services for TCP, as has been demonstrated in other areas of healthcare. 7 Therefore, the primary aim of this study was to identify the baseline factors that predict discharge destination after TCP admission.…”

Section: Introductionmentioning

confidence: 99%

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

Brusco

Taylor

Hornung³

et al. 2012

Aust. Health Review

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Objective. To investigate factors that predict discharge destination for patients making the transition from hospital to the community.Methods. Using a prospective cohort design, 696 patients from 11 Transition Care Programs were recruited. Baseline patient and program characteristics were considered for predicting discharge destination, functional status, and patient length of stay.Results. An increased physiotherapy staffing ratio in Transition Care Program was associated with an increased likelihood that a patient was discharged home, with an improved functional or mobility status, and after a shorter length of stay. The other factor that predicted discharge to home included having an Aged Care Assessment Service classification of low level care or home with a support package. An increased physiotherapy staffing level also reduced the likelihood of discharge to low level or high level care. The other factors that predicted discharge to low level care were having higher mobility status and older age; the other factor associated with increased likelihood of predicting discharge to high level care was having an Aged Care Assessment Service classification of high level care.Conclusions. Factors on admission that predicted discharge destination were program physiotherapy staffing ratios, Aged Care Assessment Service assessment, age and mobility status. What is known about the topic? In 2004/05 Australia introduced a program called the Transition Care Program (TCP), which targets older persons at the conclusion of an acute hospital episode who require more time and support in a non-acute setting to complete their restorative process and optimise their functional capacity. This program has a particular objective to prevent inappropriate admission to a residential aged care facility. To date, there are no published papers that report the factors that predict discharge destination for patients in the Transition Care Program. What does this paper add? This study provides evidence that program physiotherapy staffing ratios, Aged Care Assessment Service assessment, age and mobility status are predictive of an increased likelihood that a patient will be discharged home with an improved functional/mobility status, after a shorter length of stay. What are the implications for practitioners? Knowledge of factors that predict discharge destination may assist healthcare practitioners and health managers in managing TCP patients and planning services.

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Section: Introductionmentioning

confidence: 99%

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

Brusco

Taylor

Hornung³

et al. 2012

Aust. Health Review

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“…Possible predictive factors associated with post-stroke functional recovery and discharge destination include functional status at admission, [13][14][15] age, 9,13-16 female sex, 17,18 lesion type, 19 continence, 15,20 cognitive impairment, 21,22 premorbid independence, 21,[23][24][25] available social network, 10,26 and care giving resources. 14,15,17,[21][22][23] However, these predictive factors have varied with the settings of studies and inclusion criteria for subjects (i.e.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with functional recovery and home discharge in stroke patients admitted to a convalescent rehabilitation ward

Mutai

Furukawa

Araki

et al. 2011

Geriatrics Gerontology Int

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Aims: This study aimed to determine the predictive factors for functional recovery and home discharge in stroke patients receiving in-hospital rehabilitation.Methods: This study included a consecutive series of 174 stroke patients (average age 73.0 ± 10.8) admitted to the convalescent rehabilitation ward at Azumino Red Cross Hospital in Japan after acute rehabilitation. The main outcome measures were functional recovery (functional independence measure [FIM] at discharge and Montebello rehabilitation factor score [MRFS]) and home discharge.Results: Total FIM improved from 72.6 ± 27.6 to 87.7 ± 29.9 during the hospital stay (P < 0.001). The average MRFS was 0.34 ± 0.31. Of the 174 patients, 151 were discharged home (87%). Age, stroke type, premorbid independence, motor FIM, and cognitive FIM at admission showed a significant association with FIM at discharge, while age, premorbid independence, motor FIM at admission, and cognitive FIM at admission were statistically significant predictors of MRFS. Female sex, not living with family, premorbid independence, and neglect were negatively associated with home discharge.Conclusions: Premorbid disability and cognitive dysfunction at admission were both negatively associated with functional recovery and home discharge in patients undergoing inpatient stroke rehabilitation. Geriatr Gerontol Int 2012; 12: 215-222.

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“…In order not to overfit the data of this complex statistical model, a minimum of 10 patients per included variable was achieved limiting; however, the variables included several other important confounders for stroke recovery and could therefore not be included in this study such as neglect, attention deficits, medical complications, and medication influencing neuroplasticity such as sedatives, dopamine, or antidepressives. [1][2][3][4][5]19,20 Poststroke depression, however, was equally distributed within the groups and will be addressed later by the authors.…”

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confidence: 99%

“…[1][2][3][4][5][6] Organization and strategies of the rehabilitation seem to be particularly important because they can be influenced other than natural factors such as stroke location or age of the patient. Whereas in the US guidelines for the management of rehabilitation care are organized by an expert panel and the government, 7 in the European Union there are considerable variations in both rehabilitation care and outcome.…”

mentioning

confidence: 99%

“…5 Neurocognitive deficits such as neglect are increasingly recognized as important outcome factors as a long-time rehabilitation studies focused on motor recovery. [1][2][3][4]19 Ideally, centers should be compared that have large homogenous patient groups. 5 Another approach could be to perform smaller therapy intervention studies possibly correlating to activation pattern of functional imaging in chronic patients at least 6 months after stroke during the plateau phase of neuroplasticity to downsize the number of confounders.…”

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confidence: 99%

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Motor and Functional Recovery After Stroke

Brandt

2007

Stroke

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Prognostic Factors of Activity Limitation and Discharge Destination after Stroke Rehabilitation

Cited by 56 publications

References 33 publications

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

Factors associated with functional recovery and home discharge in stroke patients admitted to a convalescent rehabilitation ward

Motor and Functional Recovery After Stroke

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