Effect of age on functional outcomes after stroke rehabilitation
Effect of age on functional outcomes after stroke rehabilitation
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DOI：
10.1161/hs0102.101224
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发表时间：
2002-01-01
期刊：
影响因子：
8.3
通讯作者：
Hopman, W
中科院分区：
文献类型：
--
作者：
Bagg, S;Pombo, AP;Hopman, W
背景和目的--脑卒中的发病率和对脑卒中康复服务的需求持续增加，已经有人建议将年龄与脑卒中的严重程度相结合来确定康复类型。重要的是要确定年龄对功能结果的影响，然后才拥抱一个系统，限制获得康复的基础上again. Methods，这项前瞻性研究包括所有患者入院中风康复计划6年。通过图表审查提取人口统计学和临床数据。在入院和出院时的功能状态进行了评估的手段，ESTA（TM）仪器。多元回归技术被用来评估年龄，功能结果和其他预测变量之间的关系。特别注意的是r（2）值，以评估的预测变量占的变化量。结果-年龄单独是一个显着的预测因子，总的神经功能缺损评分和运动神经功能缺损评分在出院时，但不是神经功能缺损的变化。对于出院时的总分和运动功能评分，年龄仅占结局变化的3%。对于所有的模型，年龄解释了最多1.3%的功能结果的变化调整后的其他因素，如admission score. Conclusions少量的变化，可以解释的年龄单独和可疑的临床相关性，这样一个小的影响表明，没有理由拒绝患者获得康复仅仅是因为高龄。
Background and Purpose-The incidence of stroke and the demand for stroke rehabilitation services continues to increase, and it has been proposed that age be used in combination with severity of stroke to determine type of rehabilitation. It is important to identify the impact of age on functional outcome before embracing a system that limits access to rehabilitation on the basis of age.Methods-This prospective study includes all patients admitted to an inpatient stroke rehabilitation program for 6 years. Demographic and clinical data were extracted by means of chart review. Functional status at admission and discharge was evaluated by means of the FIM(TM) instrument. Multivariate regression techniques were used to assess the relationships between age, functional outcome, and other predictive variables. Particular attention was paid to the r(2) values to assess the amount of variation accounted for by the predictors.Results-Age alone was a significant predictor of total FIM score and Motor FIM score at discharge, but not FIM change. For both total FIM score and Motor FIM score at discharge, age alone accounted for only 3% of the variation in outcome. For all the models, age explained at the most 1.3% of the variation in functional outcome after adjustment for other factors, such as admission FIM score.Conclusions-The small amount of variation that can be explained by age alone and the questionable clinical relevance of such a small effect suggest that there is no justification to deny patients access to rehabilitation solely because of advanced age.