Background:
Improved risk factor management and interventions have both been shown
to improve mortality in stroke patients. Although this has been a
success for acute care, it has placed a higher burden on stroke
rehabilitation resources.
Objectives: This study sought to identify the pre-stroke rehabilitation admission factors that best predict personal care home discharge.
Methods:
Using a retrospective case-control, chart review design, 60 patients
discharged to personal care homes from inpatient stroke rehabilitation
between 2008 and 2017 were included. One hundred and eighty-two patients
discharged home over the same time span were randomly selected as
controls. Statistical analysis was used to identify patient factors
independently associated with discharge destination.
Results:
Patients were more often discharged to personal care homes if they were
older (OR 1.09; CI [1.05–1.15]), had a lower functional independence
measure score (OR 0.95; CI [0.92–0.97]), had cognitive deficits (OR
6.19; CI [2.37–18.06]), lived alone before their stroke (OR 7.77; CI
[2.75–24.55]), and whether or not there was excessive truncal
instability limiting Berg balance scale measurability (OR 0.17; CI
[0.06–0.45] if able to measure). Combined, the predictive value of
personal care home discharge using these variables was 91.6%.
Conclusions:
A combination of age, admission functional independence measure,
cognitive impairment, pre-stroke living situation, and measurability of
the Berg balance scale on admission to stroke rehabilitation were highly
predictive of eventual personal care home discharge.
Additional information
Acknowledgments
Brenden Dufault, University of Manitoba, Canada – Statistical analysis and guidance for write-up.
Kanisha Cruz-Kan, Medical Student, Faculty of Medicine, University of Manitoba, Canada – Data collection.
Himath Jayasinghe, Medical Student, Faculty of Medicine, University of Manitoba, Canada – Data collection.
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