Use of a standardized assessment to predict rehabilitation care after acute stroke

This is not really worthwhile data since currently there is no objective basis for classifying damage. Standardized measures of stroke severity and function do not correlate to any measurement of cubic cm. of dead brain and its location or any measure of penumbra damage. Until we get to size and location to describe stroke damage we can't make any comparisons at all.
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Archives of Physical Medicine and Rehabilitation , Volume 96(2) , Pgs. 210-217.

NARIC Accession Number: J70666.  What's this?
ISSN: 0003-9993.
Author(s): Stein, Joel; Bettger, Janet P.; Sicklick, Alyse; Hedeman, Robin; Magdon-Ismail, Zainab; Schwamm, Lee H..
Publication Year: 2015.
Number of Pages: 8.
Abstract: Study implemented a formal assessment of rehabilitation needs that included standardized measures of function and sociodemographic factors known to influence referral and utilization of rehabilitation after an acute stroke. The following standardized measures of stroke severity and function were collected on 736 individuals with acute ischemic and hemorrhagic stroke: National Institutes of Health Stroke Scale, premorbid modified Rankin scale, Short Portable Mental Status Questionnaire, and Barthel Index (BI). These were collected in addition to routine data in the Get With The Guidelines-Stroke registry. The main outcome of interest was discharge disposition location. Logistic regression was used to examine predictors of referral to any institution-based rehabilitation versus discharge home and referral to an inpatient rehabilitation facility (IRF) versus a skilled nursing facility (SNF). In multivariable analyses, a higher BI score (85-100) was the only factor associated with return home versus need for institution-based rehabilitation. Among patients discharged to IRF versus SNF, discharge to IRF was less likely in older patients and in those with prestroke disability and more likely in those with moderate-severe (BI score 25-40) or moderate (BI score, 45-60) activities of daily living (ADL) impairment. Formal standardized assessment of rehabilitation needs was feasible in this pilot project. Patients’ sociodemographic characteristics, premorbid function, and ADL impairment discriminated better between discharge home and institution-based rehabilitation than between IRF and SNF. Selection of IRF versus SNF appears to be influenced either by unmeasured clinical characteristics of individuals with stroke or by nonclinical factors, such as cost, geography, referral relationships, or IRF availability.
Descriptor Terms: FEASIBILITY STUDIES, MEASUREMENTS, NEEDS ASSESSMENT, OUTCOMES, REHABILITATION, STROKE.

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Citation: Stein, Joel, Bettger, Janet P., Sicklick, Alyse, Hedeman, Robin, Magdon-Ismail, Zainab, Schwamm, Lee H.. (2015). Use of a standardized assessment to predict rehabilitation care after acute stroke. Archives of Physical Medicine and Rehabilitation, 96(2), Pgs. 210-217. Retrieved 5/13/2015, from REHABDATA database.