Factors predicting clinically significant functional gain and discharge to home in stroke in-patients after rehabilitation - A retrospective cohort study.
Tony Kwun-Tak Li, Bobby Hin-Po Ng, Dora Yuk-Lin Chan and 2 others
PMID 33815025WHAT IT FOUND
Younger stroke in-patients, those with haemorrhagic stroke, and those starting with moderate motor function were linked to clinically important motor gain.
Those with family or attendant support and higher admission function were linked to going home.
Key findings
01Age under 85, haemorrhagic stroke, and an intermediate hospital motor function group were independently associated with achieving the 17-point FIM motor gain threshold.
02Premorbid living with family or an attendant and higher total FIM score at admission were independently associated with discharge to home.
03Improving by one or more levels in the hospital motor function group was independently associated with discharge to home.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study looked back at records from a single Hong Kong rehabilitation hospital, so its patterns may not apply to other settings or all stroke patients. It excluded people who lived in an old age home before stroke, died, transferred back to an acute hospital and did not return, or had missing key data, so it describes survivors who completed the rehabilitation programme. The analysis could not include walking distance, economic status, acute stroke unit care, surgery, endovascular treatment, ventilation, or intensive care details. Some cognition data were incomplete, and the sample size was small enough that less common factors may have been missed. The hospital motor function level outcome could mask gains in patients already in the highest function group. Because this was a retrospective cohort, the paper did not test treatment effects, so the listed factors are associations.
The easy way to misread this
Do not read these factors as proof that a treatment caused better recovery or home discharge. The study looked back at records and did not control for all differences between patients.