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Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici

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)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 1999 June;35(2):93-101

lingua: Inglese

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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