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Predicting discharge destination for patients with severe motor stroke: important functional tasks
P J Mokler1, R Sandstrom, M Griffin
1Alegent Health Immanuel Rehabilitation Center, Creighton University, Omaha, Nebraska 68178, USA.
Neurorehabilitation and Neural Repair
|March 29, 2001
Summary
Severe stroke patients can return home with rehabilitation. Key functional tasks like bladder management and dressing predict successful discharge, improving rehabilitation outcomes.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Health Services Research
Background:
- Stroke rehabilitation aims to maximize patient recovery and community reintegration.
- The Functional Independence Measure (FIM) is a standard tool for assessing disability and function.
- Stroke subpopulations, like FIM-FRG STR1, aid in understanding diverse patient needs.
Purpose of the Study:
- To describe outcomes for stroke patients within the FIM-FRG STR1 classification.
- To identify specific functional tasks linked to successful discharge to home after stroke rehabilitation.
Main Methods:
- Analysis of program evaluation data from 259 stroke cases (1993-1996).
- Descriptive analysis and logistic regression to identify predictors of discharge destination.
- Utilized Functional Independence Measure (FIM) variables for assessment.
Main Results:
- Three admission FIM variables (bladder management, toilet transfers, memory) were significant predictors.
- Three discharge FIM variables (upper body dressing, bed/chair transfers, comprehension) also predicted discharge destination.
- The identified FIM variables achieved up to 75% accuracy in predicting discharge destination.
Conclusions:
- Specific functional abilities at admission and discharge are crucial for successful stroke rehabilitation outcomes.
- Understanding these functional predictors can optimize rehabilitation planning and resource allocation.
- The FIM-FRG STR1 classification provides a framework for analyzing stroke patient outcomes and tailoring interventions.