Association between volume of patients undergoing stroke rehabilitation at acute care hospitals and improvement in activities of daily living
Association between volume of patients undergoing stroke rehabilitation at acute care hospitals and improvement in activities of daily living
复制标题
在急症护理医院接受中风康复的患者数量与日常生活活动改善之间的关系
DOI：
10.1016/j.jstrokecerebrovasdis.2022.106872
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发表时间：
2023
影响因子：
2.5
通讯作者：
Fushimi Kiyohide
中科院分区：
文献类型：
--
作者：
Tani Takuaki;Imai Shinobu;Inoue Norihiko;Kanazawa Natsuko;Fushimi Kiyohide
BackgroundThis study aims to determine the relationship between the annual volume of patients undergoing rehabilitation per hospital and the outcome of patients admitted for acute stroke.MethodsThis observational study used nationwide administrative data.接受康复治疗的年龄≥ 20岁的脑卒中患者的数据来自日本的1，182家急性护理医院。排除标准为住院时间延长超过180天和住院期间死亡。医院容量被分为四个四分位数的总患者每家医院。主要结局是使用Barthel指数测量的从入院到出院的日常生活活动的改善。Poisson回归分析的日常生活活动的改善进行了使用逆概率的治疗weighting.ResultsHigh康复量与日常生活活动的改善显着相关，使用“非常低组”作为参考（风险比[95%置信区间]：1.06 [1.05-1.08]，P<0.001）。低容量也与日常生活活动改善显著相关（危险比[95%可信区间]：1.04 [1.03-1.06]，P<0.001）。结论在特定医院接受多学科康复治疗的脑卒中患者的年容量可能是患者日常生活活动改善程度的一个因素
BackgroundThis study aimed to determine the relationship between the annual volume of patients undergoing rehabilitation per hospital and the outcomes of patients admitted for acute stroke.MethodsThis observational study used nationwide administrative data. Data on stroke patients aged ≥ 20 years who underwent rehabilitation were extracted from 1,182 acute care hospitals in Japan. The exclusion criteria were extended hospital stay exceeding 180 days and death during hospitalization. Hospital volumes were divided into four quartiles of total patients per hospital. The primary outcome was an improvement in activities of daily living from admission to discharge measured using the Barthel index. Poisson regression analysis of activities of daily living improvement was performed using inverse probability of treatment weighting.ResultsHigh rehabilitation volume was significantly correlated with improvements in activities of daily living using the “very low group” as a reference (risk ratio [95% confidence interval]): 1.06 [1.05–1.08], P<0.001). Low volume was also significantly associated with activities of daily living improvement (risk ratio [95% confidence interval]: 1.04 [1.03–1.06], P<0.001).ConclusionsThe annual volume of stroke patients undergoing multidisciplinary rehabilitation at a specific hospital may be a factor in the degree of patient improvement in activities of daily living