Background

This study aimed to investigate whether care capacity for patients following stroke contributes to improved activities of daily living (ADL) at discharge from hospital based on the degree of stroke severity.

Design

Retrospective, observational, longitudinal study.

Setting

Acute phase hospitals.

Participants

From 2005 to 2011, 5006 patients with stroke at acute phase hospitals were registered in a database. There were 2501 individuals from 11 hospitals who met the following four criteria: (1) a pre-stroke modified Rankin Scale (mRS) score of 0–3; (2) admission to hospital within 7 days of suffering a stroke; (3) ischemic or hemorrhagic stroke; and (4) staying in hospital for 8–60 days.

Main outcome measures

The main outcome measure was the Functional Independence Measure (FIM, version 3.0) score at discharge. The FIM is an internationally used scale, which is used as an ADL outcome assessment scale for after rehabilitation.

Results

Among patients with stroke, those with care capacity had higher FIM scores at hospital discharge than did those without care capacity (unstandardized coefficient = 2.3, P = 0.015). Examination of this relationship by stroke severity showed that the FIM score at discharge was only significantly higher in patients who suffered from a moderate to severe stroke (unstandardized coefficient = 7.0, P = 0.040). No associations were observed in patients who suffered from minor, moderate, or severe stroke.

Conclusions

These results suggest that care capacity facilitates total recovery of the FIM, especially among patients who suffer from a moderate to severe stroke.

中文翻译：

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护理能力对卒中患者日常生活活动能力恢复的影响：一项多院研究。

背景

这项研究旨在根据卒中严重程度，调查卒中后患者的护理能力是否有助于改善出院时的日常生活（ADL）。

设计

回顾性，观察性，纵向研究。

设置

急症医院。

参加者

从2005年到2011年，数据库中登记了5006例急性期医院的中风患者。来自11家医院的2501名患者符合以下四个标准：（1）脑卒中前改良兰金评分（mRS）评分为0–3；（2）中风后7天内住院；（3）缺血性或出血性中风；（4）住院8-60天。

主要观察指标

主要结局指标是出院时的功能独立性指标（FIM，3.0版）得分。FIM是国际通用的量表，用作康复后的ADL结果评估量表。

结果

在中风患者中，有护理能力的患者出院时的FIM评分高于无护理能力的患者（非标准化系数= 2.3，P  = 0.015）。通过中风严重程度检查这种关系表明，中度至重度中风患者出院时的FIM评分仅显着更高（非标准化系数= 7.0，P  = 0.040）。在轻度，中度或重度中风患者中未观察到关联。

结论

这些结果表明，护理能力有助于FIM的完全恢复，特别是在中度至重度中风患者中。