Content » Vol 52, Issue 9

Original report

Predicting admission to post-acute inpatient rehabilitation in patients with acute stroke

Feng-Hang Chang, Yen-Nung Lin, Tsan-Hon Liou, Jui-Chi Lin, Cheng-Hsun Yang, Hsien-Lin Cheng
Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei City 11031, Taiwan. E-mail: fhchang@tmu.edu.tw
DOI: 10.2340/16501977-2739

Abstract

Objective: To identify predictors of admission to post-acute inpatient rehabilitation settings follow-ing acute care for stroke survivors in Taiwan.
Design: Prospective observation study.
Participants: Stroke survivors (n = 558) admitted to acute care wards for inpatient rehabilitation (62% male; mean age 60.0 ± 12.2 years).
Methods: The primary outcome was whether survivors were admitted to post-acute inpatient rehabilitation settings after discharge from acute care wards. Logistic regression model was adopted to examine the predictors of admission to post-acute inpatient rehabilitation. A receiver operating characteristic curve was drawn to compute the ability of the predictors to discriminate the outcome.
Results: Multivariate analysis results indicated Activity Measure Post-Acute Care “6-Clicks” Basic Mobility score to be the only significant predictor of admission to post-acute inpatient rehabilitation (odds ratio = 0.44, 95% confidence interval: 0.34–0.56). Receiver operating characteristic curve analysis results indicated that the cut-off point for Basic Mobility was 13 (standardized score: 33.99). This yielded a sensitivity value of 0.98 and a specificity value of 0.96 for determining the admission to post-acute inpatient rehabilitation.
Conclusion: Activity Measure Post-Acute Care “6-Clicks” Basic Mobility subscale scores at admission for acute care can predict admission to post-acute inpatient rehabilitation for stroke survivors in Taiwan. This tool can aid clinicians in formulating adequate discharge plans at an early stage, and thus improve the quality of care.

Lay Abstract

This study aimed to identify predictors of admission to post-acute inpatient rehabilitation settings following acute care for stroke survivors in Taiwan. This was a prospective observation study. The sample comprised 558 stroke survivors admitted to acute care who received inpatient rehabilitation. The results indicate that a functional measure, the Activity Measure Post-Acute Care “6-Clicks” Basic Mobility score, was the only significant predictor of admission to post-acute inpatient rehabilitation. Stroke survivors who scored lower than 13 on this tool were more likely to be referred to inpatient rehabilitation settings. Given the short lengths of stay in acute care, the Activity Measure Post-Acute Care ”6-Clicks,” a fast and reliable measurement tool, can help clinicians to formulate adequate discharge plans at an early stage, and thus minimize inappropriate referrals and improve quality of care.

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