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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 1999 June;35(2):93-101

language: English

Predicting ­length of ­stay and func­tion­al out­come in a ­stroke reha­bil­i­ta­tion ­unit

Procicchiani D., Mammala S., La Bruna S. C., Martini E., Camurri G. B.

Divisione Recupero Rieducazione Funzionale, Ospedale Santa Maria Nuova - Reggio Emilia, Italy


BACKGROUND: Stroke is the ­most com­mon diag­nos­es: for ­patients admit­ted to reha­bil­i­ta­tion ­units. This ­study ­aimed to inves­ti­gate wheth­er ­data avail­able in the ­first few ­days ­after admis­sion ­could ­help to pre­dict ­length of ­stay and func­tion­al out­come.
METHODS: We inves­ti­gat­ed a con­sec­u­tive sam­ple in a 40-bed reha­bil­i­ta­tion ­unit of a gen­er­al hos­pi­tal. The sur­vey last­ed 18 ­months and includ­ed 107 con­sec­u­tive ­stroke ­patients, 56 ­females, 51 ­males, admit­ted to an inten­sive reha­bil­i­ta­tion ­unit ­from ­acute ­care ­wards. Length of ­stay and Functional Independence Measure (FIM) ­were ­used as out­come meas­ures. A com­pre­hen­sive set of dem­o­graph­ic and med­i­cal infor­ma­tion was col­lect­ed at the ­time of admis­sion. All ­patients ­were ­assessed for impair­ment and dis­abil­ity at the ­time of admis­sion and dis­charge ­using the Motricity Index (MI), Trunk Control Test (TCT), Hodkinson Abbreviated Mental Test (­HAMT) and the FIM. Analysis of var­i­ance and mul­ti­ple regres­sion ­were ­used to esti­mate the influ­ence of inde­pen­dent var­i­ables on ­stroke out­come.
RESULTS: A ­stable regres­sion mod­el for ­length of ­stay includ­ed leg MI and FIM as inde­pen­dent var­i­ables, and ­explained 27% of var­i­ance. For func­tion­al out­come, the regres­sion mod­el includ­ed TCT and FIM and the ­explained var­i­ance ­rose to 60%. The ­effect of age on func­tion­al out­come was test­ed by anal­y­sis of covar­i­ance and, ­after con­trol­ling for dis­abil­ity at the ­time of admis­sion, ­found non sig­nif­i­cant.
CONCLUSIONS: Our ­data ­shows ­that func­tion­al out­come is easi­er to pre­dict ­than ­length of ­stay. However, ­even the ­best mod­el, ­which pre­dicts func­tion­al out­come, was asso­ciat­ed ­with a stan­dard ­error of esti­mate of ±20 FIM ­scores. This is low on aver­age, but ­still too ­high for selec­tion at the ­time of admis­sion. We ­think ­that all ­stroke ­patients ­should ­have ­access to a reha­bil­i­ta­tion pro­gramme, but in dif­fer­ent set­tings.

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