Proactive rehabilitation screening (PReS) - development and validation of a modified PReS tool to screen admitted patients needing in-hospital rehabilitation programs.

IF 2.1 4区医学 Q1 REHABILITATION

Disability and Rehabilitation Pub Date : 2025-06-20 DOI:10.1080/09638288.2025.2512590

Jane Wu, Yuriko Watanabe, Nicholas Olsen, Swee-Ling Toh, Abraham Arulanandam, Christine T Shiner

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引用次数: 0

Abstract

Purpose: To analyse the predictive performance of Proactive Rehabilitation Screening (PReS) tool in identifying hospitalised patients who require formal inpatient multidisciplinary rehabilitation program.

Methods: A prospective observational cohort study was conducted in two Australian public hospitals. The aims were to (1) assess the original PReS tool's ability to predict rehabilitation needs and (2) develop and validate a modified PReS tool. Regression analysis was used to re-estimate predictor weights.

Results: In the development cohort (n = 1600), 272 patients (17%) received rehabilitation. Using multivariate regression analysis, we identified five key variables (age, number of allied health sessions received in 5 days, assistance required to mobilise, new personal care impairment and discharge barriers) to modify the original PReS tool. The modified PReS scores were stratified into likelihood of rehabilitation: low (0-4), medium (5-13) and high (14-20). Performance was improved for medium likelihood when a rehabilitation clinician was included in decision making. This was validated in an independent cohort of 800 patients demonstrating good predictive performance: sensitivity of 81.1%, specificity of 88.0%, total accuracy 86.9%.

Conclusion: The modified PReS tool can reliably identify patients at risk of needing rehabilitation using five easily obtained clinical variables, enabling timely evidence-based rehabilitation interventions to minimise disability.

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主动康复筛查(PReS) -改进PReS工具的开发和验证，用于筛查需要住院康复计划的住院患者。

目的：分析主动康复筛查（PReS）工具在识别需要正式住院多学科康复计划的住院患者中的预测性能。方法：在澳大利亚两所公立医院进行前瞻性观察队列研究。目的是：(1)评估原始PReS工具预测康复需求的能力；(2)开发和验证改进的PReS工具。回归分析用于重新估计预测因子权重。结果：在发展队列（n = 1600）中，272例（17%）患者接受了康复治疗。使用多变量回归分析，我们确定了五个关键变量（年龄、5天内接受的联合医疗会议次数、动员所需的援助、新的个人护理障碍和出院障碍）来修改原始PReS工具。改良后的PReS评分分为康复可能性低（0-4）、中（5-13）和高（14-20）。当康复临床医生参与决策时，表现在中等可能性上得到改善。该方法在800例患者的独立队列中得到验证，显示出良好的预测性能：敏感性为81.1%，特异性为88.0%，总准确性为86.9%。结论：改进的PReS工具可以通过5个容易获得的临床变量可靠地识别需要康复的患者，从而及时进行循证康复干预，最大限度地减少残疾。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Disability and Rehabilitation 医学-康复医学

CiteScore

5.00

自引率

9.10%

发文量

415

审稿时长

3-6 weeks

期刊介绍： Disability and Rehabilitation along with Disability and Rehabilitation: Assistive Technology are international multidisciplinary journals which seek to encourage a better understanding of all aspects of disability and to promote rehabilitation science, practice and policy aspects of the rehabilitation process.