Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Saturday, May 19, 2018

Clinical and psychosocial predictors of exceeding target length of stay during inpatient stroke rehabilitation

You'll have to ask what the LOS(Length of stay) definition is and how it applies to you. I bet it doesn't say; open ended until you get to 100% recovery. You will have to forcefully push back that only results will be length of stay targets. 100% recovery is the only goal. Start demanding that, your doctors will try to use the tyranny of low expectations to get you out of the hospital faster.
https://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J78321&phrase=no&rec=136373&article_source=Rehab&international=0&international_language=&international_location=
Topics in Stroke Rehabilitation , Volume 24(7) , Pgs. 510-516.

NARIC Accession Number: J78321.  What's this?
ISSN: 1074-9357.
Author(s): Lai, Wesley; Buttineau, Mackenzie; Harvey, Jenifer; Pucci, Rebecca A.; Wong, Anna P. M.; Dell'Erario, Linda; Bosynak, Stephanie; Reid, Shannon.
Publication Year: 2017.
Number of Pages: 7.
Abstract: Study evaluated the extent to which post-stroke patients at an inpatient rehabilitation hospital are meeting length of stay (LOS) targets and identified patient characteristics that predict exceeding target LOS. In Ontario, Canada, patients admitted to inpatient rehabilitation hospitals after a stroke are classified into rehabilitation patient groups based on age and functional level. Clinical practice guidelines, called quality-based procedures, recommend a target LOS for each group. Participants included adult patients with stroke, admitted to an inpatient rehabilitation hospital between 2014 and 2015. The percentage of patients exceeding the recommended target LOS was determined. Logistic regression was performed to identify clinical and psychosocial patient characteristics associated with exceeding target LOS after adjusting for stroke severity. Of 165 patients, 38.8 percent exceeded their target LOS. Presence of ataxia, recurrent stroke, living alone, absence of a caregiver at admission, and acquiring a caregiver during hospital LOS were each associated with significantly higher odds of exceeding target LOS in comparison to patients without these characteristics, after adjusting for stroke severity. Findings suggest that social and stroke-specific factors may be helpful to adjust LOS expectations and promote efficient resource allocation. This exploratory study was limited to findings from one urban rehabilitation hospital. Cross-validation of results using data-sets from multiple rehabilitation hospitals across Ontario is recommended.
Descriptor Terms: HEALTH CARE, INTERNATIONAL REHABILITATION, MEDICAL ASPECTS, OUTCOMES, PREDICTION, PSYCHOSOCIAL FACTORS, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Lai, Wesley, Buttineau, Mackenzie, Harvey, Jenifer, Pucci, Rebecca A., Wong, Anna P. M., Dell'Erario, Linda, Bosynak, Stephanie, Reid, Shannon. (2017). Clinical and psychosocial predictors of exceeding target length of stay during inpatient stroke rehabilitation.  Topics in Stroke Rehabilitation , 24(7), Pgs. 510-516. Retrieved 5/19/2018, from REHABDATA database.

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