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Predictors of Discharge Destination After Stroke
Theresa Schrage1, Götz Thomalla2, Martin Härter1
1Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
Neurorehabilitation and Neural Repair
|April 11, 2023
Summary
Stroke patient discharge destination is influenced by factors like stroke severity and living situation. Understanding these predictors aids in care planning and resource allocation for better patient outcomes.
Area of Science:
- Neurology
- Public Health
- Health Services Research
Background:
- Determining discharge destination post-acute stroke care is crucial for mitigating long-term disabilities.
- Effective discharge planning improves healthcare cost efficiency and patient recovery trajectories.
Purpose of the Study:
- To investigate discharge destinations for patients following acute stroke treatment.
- To identify key personal, social, stroke-related, and clinical predictors influencing stroke patient discharge location.
Main Methods:
- Secondary analysis of a prospective observational study involving 1026 patients with acute ischemic stroke, transient ischemic attack, or intracerebral hemorrhage.
- Hierarchical multinomial logistic regression was employed to identify predictors of discharge destination.
- Data collected over a 15-month period from consecutive patient recruitment.
Main Results:
- 55% of stroke patients were discharged home, 33% to rehabilitation, 3% to residential facilities, and 8% to other acute care hospitals.
- Significant predictors of discharge destination included age, pre-stroke living situation and location, stroke type and severity, treatment type, and length of stay.
- Increased stroke severity was associated with discharge to all four types of inpatient facilities.
Conclusions:
- Stroke severity and pre-stroke living situation significantly predict discharge destination, aligning with prior research.
- Pre-existing conditions and pre-stroke functional impairment did not significantly impact discharge destination in this cohort.
- Discrepancies may stem from a functionally robust study sample and the specific outcome measures utilized.
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