Factors Associated to Returning Home in the First Year after Stroke

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Public Health

Background:

• Stroke is a leading cause of long-term disability, necessitating effective post-stroke care and rehabilitation strategies.
• Understanding factors influencing a stroke survivor's discharge destination is critical for optimizing recovery and resource allocation.
• Previous research has identified various factors, but a comprehensive analysis of post-stroke return home in a Korean cohort is needed.

Purpose of the Study:

• To investigate demographic, environmental, clinical, and psychological factors associated with stroke survivors returning home one year post-stroke.
• To identify key predictors influencing discharge disposition (home vs. rehabilitation hospitalization) in stroke patients.

Main Methods:

• Analysis of a large-scale, multi-objective cohort study involving 563 initial-stage stroke patients from 9 Korean hospitals.
• Comparison of patients discharged home (464) versus those hospitalized in rehabilitation facilities (99) one year after stroke.
• Evaluation of demographic, environmental, clinical (e.g., Functional Ambulation Categories, modified Rankin Scale), and psychological (e.g., Geriatric Depression Scale) variables.

Main Results:

• Significant differences were observed between the groups in job status, housing convenience, residential type, diagnosis, and various functional assessments.
• Key factors influencing return home included functional status, activities of daily living, cognition, depression, stress, quality of life, and employment status.
• The study identified specific clinical and psychological markers that differentiate between returning home and requiring further institutional rehabilitation.

Conclusions:

• Functional status, cognitive function, psychological well-being (depression, stress), quality of life, and socioeconomic factors (job status) are critical determinants of discharge destination post-stroke.
• These findings provide essential data for developing personalized rehabilitation goals and treatment plans to facilitate successful home-based recovery.
• The study underscores the importance of a holistic approach to stroke rehabilitation, considering not only clinical recovery but also psychosocial and environmental factors.