Clinical Indicators and Thresholds for Determining Discharge Destination from Acute Stroke Ward

Abstract

Objective: The present study aimed to investigate the complex interaction of factors affecting discharge destination after the acute phase of stroke. Methods: In 304 patients with stroke who required rehabilitation, we focused on three discharge destinations (i.e., home, convalescent rehabilitation ward, and other facility). Sociodemographic, medical, and acute symptoms data, within the first week of stroke onset and discharge destination, were collected from acute stroke wards. The complex interaction of factors relating to discharge destination from an acute stroke ward was investigated by classification and regression tree analysis. Results: Patients with a total Functional Independence Measure (FIM) score > 35, a Brunnstrom recovery stage of the lower limb > V, and a comprehension FIM score > 5 had a 91.7% chance of home discharge. By contrast, patients with a total FIM score ≤ 35, age ≤ 79.5 years, and > 2.5 family members had an 80% chance of discharge to a convalescent rehabilitation ward. Finally, patients with a total FIM score ≤ 35, age > 79.5 years, and an expression FIM score ≤ 3 had a 78.6% chance of discharge to other facilities. Conclusion: The interaction of independence on FIM, function of the paralyzed lower limb, age, number of family members, and comprehension or expression function affect the choice of discharge destination from acute stroke wards.