Fan He, Irene Blackberry, Michael Njovu, David Rutherford, George Mnatzaganian
{"title":"Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital.","authors":"Fan He, Irene Blackberry, Michael Njovu, David Rutherford, George Mnatzaganian","doi":"10.2340/jrm.v57.42506","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The impact of delayed inpatient rehabilitation on the functional outcomes of stroke patients has not been reported in regional Australia.</p><p><strong>Objective: </strong>This study examined the impact of delayed inpatient rehabilitation following acute stroke on functional outcomes (Relative Functional Gain and Functional Independence Measure efficiency) and length of stay in rehabilitation at a regional Australian hospital.</p><p><strong>Methods: </strong>Rehabilitation initiated > 24 h after a patient was deemed clinically ready was considered delayed. Associations between delayed inpatient rehabilitation and functional outcomes were investigated with mixed effects linear regression while length of stay was modelled using a negative binomial regression.</p><p><strong>Results: </strong>Of a total 487 patients, 301 (61.8%) experienced delayed inpatient rehabilitation, with a median delay of 2 days (interquartile range: 1-4 days). Multivariate regressions showed delayed inpatient rehabilitation was negatively associated with Relative Functional Gain (Beta: -0.07, 95% confidence interval [CI]: -0.11, -0.02, p = 0.009) and Functional Independence Measure efficiency (Beta: -0.18, 95% CI: -0.32, -0.04, p = 0.014), but positively associated with length of stay in rehabilitation wards (incidence rate ratio: 1.11, 95% CI: 1.02, 1.21, p = 0.021). Bed unavailability was the leading cause of delay.</p><p><strong>Conclusion: </strong>Delayed inpatient rehabilitation is associated with poorer functional outcomes in stroke patients. Timely access to rehabilitation is crucial for optimising recovery.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42506"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340994/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Rehabilitation Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2340/jrm.v57.42506","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The impact of delayed inpatient rehabilitation on the functional outcomes of stroke patients has not been reported in regional Australia.
Objective: This study examined the impact of delayed inpatient rehabilitation following acute stroke on functional outcomes (Relative Functional Gain and Functional Independence Measure efficiency) and length of stay in rehabilitation at a regional Australian hospital.
Methods: Rehabilitation initiated > 24 h after a patient was deemed clinically ready was considered delayed. Associations between delayed inpatient rehabilitation and functional outcomes were investigated with mixed effects linear regression while length of stay was modelled using a negative binomial regression.
Results: Of a total 487 patients, 301 (61.8%) experienced delayed inpatient rehabilitation, with a median delay of 2 days (interquartile range: 1-4 days). Multivariate regressions showed delayed inpatient rehabilitation was negatively associated with Relative Functional Gain (Beta: -0.07, 95% confidence interval [CI]: -0.11, -0.02, p = 0.009) and Functional Independence Measure efficiency (Beta: -0.18, 95% CI: -0.32, -0.04, p = 0.014), but positively associated with length of stay in rehabilitation wards (incidence rate ratio: 1.11, 95% CI: 1.02, 1.21, p = 0.021). Bed unavailability was the leading cause of delay.
Conclusion: Delayed inpatient rehabilitation is associated with poorer functional outcomes in stroke patients. Timely access to rehabilitation is crucial for optimising recovery.
期刊介绍:
Journal of Rehabilitation Medicine is an international peer-review journal published in English, with at least 10 issues published per year.
Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics, including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.