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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Online ISSN 1973-9095
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.