Development and validation of a discharge planning index for achieving home discharge after hospitalization for acute stroke among those who received rehabilitation services.
Development and validation of a discharge planning index for achieving home discharge after hospitalization for acute stroke among those who received rehabilitation services.
复制标题
制定和验证出院计划指数，以便接受康复服务的急性中风住院患者能够出院回家。
DOI：
10.1097/phm.0b013e3182a92bfb
复制
发表时间：
2014
影响因子：
3
通讯作者：
Xie,Dawei
中科院分区：
文献类型：
--
作者：
Stineman,MargaretG;Kwong,PuiL;Bates,BarbaraE;Kurichi,JibbyE;Ripley,DianeCowper;Xie,Dawei
本研究的目的是开发一个指数，用于建立出院回家的概率住院治疗急性中风使用有关以前的生活环境，合并症，医院的过程中，和身体等级和认知阶段的独立性achieved.DesignThis是一个纵向观察人群为基础的研究。所有6515人治疗急性中风谁收到康复服务，在110退伍军人事务设施在2 yr period included.ResultsThere是8个独立的预测因素的家庭出院确定，并通过逻辑回归点分配：已婚（2分）;入院前位置（延伸护理= 0分，其他医院= 9分，家庭= 11分）;出院身体评分（I、II或III级= 0分; IV或V级= 3分; VI或VII级= 5分）;出院认知阶段（I期= 0分; II、III、IV或V期= 3分; VI或VII期= 5分）;无肝脏疾病（2分）、机械通气（3分）、非经口进食（2分）和入住重症监护室（1分）。将所有现有因素的得分相加以计算得分。出院回家的概率范围从65.03%（最不可能的组）（≤ 21分）到98.24%（最可能的组）（≥ 27分）。结论治疗团队可能会应用该指数的预后估计出院计划和功能目标设定后，初步物理医学和康复评估。
ObjectiveThe aim of this study was to develop an index for establishing the probability of being discharged home after hospitalization for acute stroke using information about previous living circumstances, comorbidities, hospital course, and the physical grades and cognitive stages of independence achieved.DesignThis is a longitudinal observational population-based study. All 6515 persons treated for acute stroke who received rehabilitation services in 110 Veterans Affairs facilities within a 2-yr period were included.ResultsThere were eight independent predictors of home discharge identified, and points were assigned through logistic regression: married (2 points); location before hospitalization (extended care= 0 points, other hospital= 9 points, home= 11 points); discharge physical grade (grade I, II, or III= 0 points; grade IV or V= 3 points; grade VI or VII= 5 points); discharge cognitive stage (stage I= 0 points; stage II, III, IV, or V= 3 points; stage VI or VII= 5 points); and absence of liver disease (2 points), mechanical ventilation (3 points), nonoral feeding (2 points), and intensive care unit admission (1 point). The points were added for all present factors to calculate scores. The probabilities of home discharge ranged from 65.03% in the least likely (≤ 21 points) to 98.24% in the most likely group (≥ 27 points).ConclusionsThe treatment team might apply prognostic estimates from this index in discharge planning and functional goal setting after initial physical medicine and rehabilitation assessment.