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

IF 2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
International Journal of General Medicine Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S547223
Wei-Ting Liu, Huey-Juan Lin, Poh-Shiow Yeh
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引用次数: 0

摘要

目的:评估脑卒中幸存者持续护理资源的使用情况及其出院后3个月的功能状况。患者和方法:本单中心回顾性队列研究纳入了2021年7月至2022年6月在奇美医疗中心住院的短暂性脑缺血发作或急性缺血性脑卒中患者。采用改良Rankin量表(mRS)将患者的放电功能状态分为:I组(0-2)、II组(3)、III组(4-5)。从医疗记录和电话随访中收集出院计划、医疗依从性、再入院和3个月结局的数据。分组比较采用Kruskal-Wallis和卡方或Fisher精确检验(双侧,α)结果:897例患者中,754例符合纳入标准:I组(50%),II组(21%)和III组(29%)。II组和III组患者年龄较大,卒中和合并症更为严重。出院目的地各不相同:第一组96%的人回家了,第二组59%,第三组33%。大约三分之一的第二组和第三组患者接受了急性后护理(PAC), 27%的第三组患者出院到护理机构。医疗依从性高(96-97%),第三组有17%接受家庭医疗护理。长期护理(LTC) 2.0服务被14%的II组和III组使用。3个月时,第1组10%、第2组50%和第3组89%的患者出现残疾或死亡。第二组和第三组三分之二的患者拔掉了医用试管。再入院率在10-17%之间,第三组最高,主要是由于复发性中风或感染。半数PAC参与者表现出功能改善。结论:脑卒中幸存者根据出院功能状态有不同的护理需求和结局。优化出院计划和促进PAC和LTC 2.0服务可以改善康复,特别是对于严重残疾的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Continuum of Care and 3-month Outcomes in Acute Ischemic Stroke Patients Stratified by Discharge Functional Status: A Single-Center Retrospective Cohort Study.

Continuum of Care and 3-month Outcomes in Acute Ischemic Stroke Patients Stratified by Discharge Functional Status: A Single-Center Retrospective Cohort Study.

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.

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来源期刊
International Journal of General Medicine
International Journal of General Medicine Medicine-General Medicine
自引率
0.00%
发文量
1113
审稿时长
16 weeks
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.
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