Delayed inpatient rehabilitation and functional outcomes for acute stroke: a retrospective cohort study in an Australian regional hospital.

IF 2.3 4区 医学 Q1 REHABILITATION
Fan He, Irene Blackberry, Michael Njovu, David Rutherford, George Mnatzaganian
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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.

急性脑卒中延迟住院康复和功能结局:澳大利亚一家地区医院的回顾性队列研究
背景:澳大利亚地区尚未报道延迟住院康复对脑卒中患者功能结局的影响。目的:本研究考察了澳大利亚一家地区医院急性卒中后延迟住院康复对功能结局(相对功能增益和功能独立测量效率)和康复住院时间的影响。方法:在患者被认为临床准备就绪24小时后才开始进行康复治疗。延迟住院康复与功能预后之间的关系采用混合效应线性回归进行研究,而住院时间使用负二项回归进行建模。结果:在总共487例患者中,301例(61.8%)出现住院康复延迟,中位延迟为2天(四分位数范围:1-4天)。多因素回归显示,延迟住院康复与相对功能增益(Beta: -0.07, 95%可信区间[CI]: -0.11, -0.02, p = 0.009)和功能独立性测量效率(Beta: -0.18, 95% CI: -0.32, -0.04, p = 0.014)呈负相关,与康复病房住院时间呈正相关(发病率比:1.11,95% CI: 1.02, 1.21, p = 0.021)。没有床位是延误的主要原因。结论:延迟住院康复与脑卒中患者较差的功能预后相关。及时获得康复服务对于优化康复至关重要。
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来源期刊
CiteScore
5.60
自引率
5.70%
发文量
102
审稿时长
4-8 weeks
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.
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