{"title":"按出院功能状态分层的急性缺血性卒中患者的连续护理和3个月结局:一项单中心回顾性队列研究","authors":"Wei-Ting Liu, Huey-Juan Lin, Poh-Shiow Yeh","doi":"10.2147/IJGM.S547223","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate use of continuous care resources among stroke survivors and their 3-month outcomes by discharge functional status.</p><p><strong>Patients and methods: </strong>This single-center retrospective cohort study included patients with transient ischemic attack or acute ischemic stroke admitted to Chi Mei Medical Center from July 2021 to June 2022. Discharge functional status was categorized by the modified Rankin Scale (mRS): Group I (0-2), Group II (3), and Group III (4-5). Data on discharge planning, medical adherence, readmissions, and 3-month outcomes were collected from medical records and telephone follow-ups. Group comparisons used Kruskal-Wallis and chi-square or Fisher's exact tests (two-sided, α<0.05).</p><p><strong>Results: </strong>Of 897 patients, 754 met inclusion criteria: Group I (50%), Group II (21%), and Group III (29%). Groups II and III were older with more severe strokes and comorbidities. Discharge destination varied: 96% of Group I returned home, versus 59% of Group II, and 33% of Group III. About one-third of Groups II and III received post-acute care (PAC), and 27% of Group III were discharged to nursing facilities. Medical adherence was high (96-97%), and 17% of Group III received home medical care. Long-Term Care (LTC) 2.0 services were utilized by 14% of Groups II and III. At 3 months, disability (mRS > 2) or death occurred in 10% of Group I, 50% of Group II, and 89% of Group III. Two-thirds of Groups II and III had medical tubes removed. Readmissions ranged from 10-17%, highest in Group III, mainly due to recurrent strokes or infections. Half of PAC participants showed functional improvements.</p><p><strong>Conclusion: </strong>Stroke survivors have distinct care needs and outcomes by discharge functional status. Optimizing discharge planning and facilitating PAC and LTC 2.0 services may improve recovery, particularly for patients with significant disabilities.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5665-5672"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452980/pdf/","citationCount":"0","resultStr":"{\"title\":\"Continuum of Care and 3-month Outcomes in Acute Ischemic Stroke Patients Stratified by Discharge Functional Status: A Single-Center Retrospective Cohort Study.\",\"authors\":\"Wei-Ting Liu, Huey-Juan Lin, Poh-Shiow Yeh\",\"doi\":\"10.2147/IJGM.S547223\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate use of continuous care resources among stroke survivors and their 3-month outcomes by discharge functional status.</p><p><strong>Patients and methods: </strong>This single-center retrospective cohort study included patients with transient ischemic attack or acute ischemic stroke admitted to Chi Mei Medical Center from July 2021 to June 2022. Discharge functional status was categorized by the modified Rankin Scale (mRS): Group I (0-2), Group II (3), and Group III (4-5). Data on discharge planning, medical adherence, readmissions, and 3-month outcomes were collected from medical records and telephone follow-ups. Group comparisons used Kruskal-Wallis and chi-square or Fisher's exact tests (two-sided, α<0.05).</p><p><strong>Results: </strong>Of 897 patients, 754 met inclusion criteria: Group I (50%), Group II (21%), and Group III (29%). Groups II and III were older with more severe strokes and comorbidities. Discharge destination varied: 96% of Group I returned home, versus 59% of Group II, and 33% of Group III. About one-third of Groups II and III received post-acute care (PAC), and 27% of Group III were discharged to nursing facilities. Medical adherence was high (96-97%), and 17% of Group III received home medical care. Long-Term Care (LTC) 2.0 services were utilized by 14% of Groups II and III. At 3 months, disability (mRS > 2) or death occurred in 10% of Group I, 50% of Group II, and 89% of Group III. Two-thirds of Groups II and III had medical tubes removed. Readmissions ranged from 10-17%, highest in Group III, mainly due to recurrent strokes or infections. Half of PAC participants showed functional improvements.</p><p><strong>Conclusion: </strong>Stroke survivors have distinct care needs and outcomes by discharge functional status. Optimizing discharge planning and facilitating PAC and LTC 2.0 services may improve recovery, particularly for patients with significant disabilities.</p>\",\"PeriodicalId\":14131,\"journal\":{\"name\":\"International Journal of General Medicine\",\"volume\":\"18 \",\"pages\":\"5665-5672\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452980/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of General Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/IJGM.S547223\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of General Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJGM.S547223","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Continuum of Care and 3-month Outcomes in Acute Ischemic Stroke Patients Stratified by Discharge Functional Status: A Single-Center Retrospective Cohort Study.
Purpose: To evaluate use of continuous care resources among stroke survivors and their 3-month outcomes by discharge functional status.
Patients and methods: This single-center retrospective cohort study included patients with transient ischemic attack or acute ischemic stroke admitted to Chi Mei Medical Center from July 2021 to June 2022. Discharge functional status was categorized by the modified Rankin Scale (mRS): Group I (0-2), Group II (3), and Group III (4-5). Data on discharge planning, medical adherence, readmissions, and 3-month outcomes were collected from medical records and telephone follow-ups. Group comparisons used Kruskal-Wallis and chi-square or Fisher's exact tests (two-sided, α<0.05).
Results: Of 897 patients, 754 met inclusion criteria: Group I (50%), Group II (21%), and Group III (29%). Groups II and III were older with more severe strokes and comorbidities. Discharge destination varied: 96% of Group I returned home, versus 59% of Group II, and 33% of Group III. About one-third of Groups II and III received post-acute care (PAC), and 27% of Group III were discharged to nursing facilities. Medical adherence was high (96-97%), and 17% of Group III received home medical care. Long-Term Care (LTC) 2.0 services were utilized by 14% of Groups II and III. At 3 months, disability (mRS > 2) or death occurred in 10% of Group I, 50% of Group II, and 89% of Group III. Two-thirds of Groups II and III had medical tubes removed. Readmissions ranged from 10-17%, highest in Group III, mainly due to recurrent strokes or infections. Half of PAC participants showed functional improvements.
Conclusion: Stroke survivors have distinct care needs and outcomes by discharge functional status. Optimizing discharge planning and facilitating PAC and LTC 2.0 services may improve recovery, particularly for patients with significant disabilities.
期刊介绍:
The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas.
A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal.
As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.