Long-term prediction of functional outcome after stroke using single items of the Barthel Index at discharge from rehabilitation centre
Long-term prediction of functional outcome after stroke using single items of the Barthel Index at discharge from rehabilitation centre
复制标题
使用康复中心出院时 Barthel 指数的单项对中风后功能结果进行长期预测
DOI：
10.3109/09638288.2013.793411
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发表时间：
2014
影响因子：
2.2
通讯作者：
W. Schupp
中科院分区：
文献类型：
--
作者：
L. de Wit;K. Putman;H. Devos;Nadine Brinkmann;E. Dejaeger;W. D. De Weerdt;W. Jenni;N. Lincoln;Birgit Schuback;W. Schupp
目的：探讨康复出院时Barthel指数单项指标对脑卒中患者5年个人日常生活活动独立性（BI评分≥95/100）的预测价值。方法：从四个欧洲康复中心连续招募中风患者。BI在出院时和中风后5年进行评估。采用逐步多因素logistic回归分析确定脑卒中后5年BI评分≥95/100的独立预测因子。计算脑卒中后5年BI≥95/100的百分比。结果：153例患者获得数据。穿衣独立性(优势比（OR) = 5.22, 95%可信区间(CI) = 1.85 ~ 14.76, p = 0.002）和沐浴独立性（OR = 8.10, 95% CI = 3.40 ~ 19.32, p < 0.0001）为独立预测因子。两项的独立性导致卒中后5年BI≥95/100的几率为74.1%（57.6-85.8）。两项的相关性导致6.3%（5.1-7.9）的几率。洗澡独立、穿衣依赖发生率分别为35.4%（30.7 ~ 40.4）和26.1%（20.7 ~ 32.3）。结论：对康复出院时换药沐浴进行简单评估，可帮助治疗人员预测个人ADL长期独立的预后。该方法可用于早期识别需要密切随访的中风患者。康复中心出院后穿衣和洗澡的康复依赖是预测中风后5年个人生活自理（ADL）依赖的重要因素。该预测工具可用于针对住院卒中患者的康复和早期识别那些需要加强随访的患者。
Abstract Purpose: To determine the prognostic value of single items of the Barthel Index (BI) at discharge from rehabilitation, in predicting independence in personal activities of daily living (ADL) (BI score ≥95/100) at five years after stroke. Method: People with stroke were recruited consecutively from four European rehabilitation centres. BI was assessed on discharge and at five years after stroke. Stepwise multivariate logistic regression analysis was used to determine independent predictors of BI score ≥95/100 at five years after stroke. Thereupon, percentage chance of reaching BI ≥ 95/100 at five years after stroke was calculated. Results: Data were available for 153 patients. Independence in dressing (odds ratio (OR) = 5.22, 95% confidence interval (CI) = 1.85–14.76, p = 0.002) and bathing (OR = 8.10, 95% CI = 3.40–19.32, p < 0.0001) were independent predictors. Independence in both items resulted in 74.1% (57.6–85.8) chance of reaching BI ≥ 95/100 at five years after stroke. Dependence in both items resulted in 6.3% (5.1–7.9) chance. Independence in bathing, but dependence in dressing resulted in 35.4% (30.7–40.4) chance whereas the opposite resulted in 26.1% (20.7–32.3) chance. Conclusion: Simple assessment of dressing and bathing on discharge from rehabilitation enables therapeutic staff to predict prognosis for long-term independence in personal ADL. This method can be used for early identification of persons with stroke who need intensive follow-up. Implications for Rehabilitation (In)dependence for dressing and bathing at discharge from a rehabilitation centre are significant factors in the prediction of (in)dependence in personal ADL at five years after stroke. This predictive tool can be used for targeting inpatient stroke rehabilitation and early identification of those patients who need intensive follow-up.