Factors Influencing Outcome and Length of Stay in a Stroke Rehabilitation Unit Part 1. Analysis of 248 Unscreened Patients ‐Medical and Functional Prognostic Indicators
Factors Influencing Outcome and Length of Stay in a Stroke Rehabilitation Unit Part 1. Analysis of 248 Unscreened Patients ‐Medical and Functional Prognostic Indicators
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影响中风康复科结果和住院时间的因素第 1 部分：248 名未经筛查患者的分析 - 医疗和功能预后指标
作者：
J. Feigenson;F. Mcdowell;P. Meese;S. D. Greenberg
回顾性分析了248例中风患者（平均年龄67岁，范围17-98岁）在16个月的时间内入住中风康复部门，结果显示80%的患者在平均住院时间（LOS）为43天后能够回家。出院时，85%的患者可以走动，56%的患者在日常生活活动中不需要帮助。入院时虚弱的严重程度、较长的入院间隔、存在严重的知觉或认知功能障碍或伴有运动缺陷的偏盲与不良结果和LOS增加有关。患者的年龄、吞咽障碍或半感觉障碍以及虚弱、糖尿病、高血压或ASHD与患者出院时的功能状态、出院处置或LOS无关。许多“预后不良症状”的患者在入院后有明显改善，随后出院。因此，虽然上述发现可以预测哪些患者可以在短期治疗设施中获得最大收益，但它们也表明，大多数患者，即使是那些“预后不良迹象”的患者，在相对较短的住院治疗后，也可以在家中获得足够的功能改善。
A retrospective analysis of 248 patients with stroke (average age 67, range 17-98) admitted to a stroke rehabilitation unit over a sixteen month period showed that 80% of these patients were able to return home after an average length of stay (LOS) of 43 days. At discharge 85% of the group were ambulatory and 56% required no help in daily living activities. Severity of weakness on admission, long onsetadmission intervals, the presence of severe perceptual or cognitive dysfunction or a homonymous hemianopsia in addition to a motor deficit were related to unfavorable outcome and increased LOS. The age of the patient, dysphasia or a hemisensory deficit in addition to weakness, or diabetes, hypertension, or ASHD were unrelated to the patients' functional status on discharge, discharge disposition, or LOS. Many patients with “unfavorable prognostic signs” made significant improvement after admission and were subsequently discharged. Thus, while the above findings may predict which patients can make maximal gains in a short term treatment facility, they also show that most patients, even those with “poor prognostic signs,” can make enough functional improvement to be managed at home after a relatively short hospitalization.