Affiliations: [a]
University of Michigan Medical Center, Ann Arbor, MI | [b]
Veterans Affairs Medical Center, Ann Arbor, MI | [c]
Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel | [d]
Loewenstein Hospital Rehabilitation Center, Ra’anana, Israel
Note: [1] This investigation was funded by a Clinical Investigator Development Award (NS-01120-03) to Professor Davidoff from the National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Medicine and Surgery, United States Department of Veterans Affairs, Washington DC; the World Rehabilitation Fund, New York City, NY; the Kenny Michigan Rehabilitation Foundation, Southfield, MI, and a Research Training Grant (H133P80017) from the National Institute on Disability and Rehabilitation Research, United States Department of Education, Washington, DC.
Note: [†] Deceased.
Abstract: The purpose of this study was to develop a simple protocol for use in screening “middle band” stroke patients to determine who would most likely achieve discharge to an independent community setting after intensive inpatient rehabilitation. A case-control comparison was made of patients who were discharged from inpatient rehabilitation after an initial middle band stroke, either to home (n=141) or to an extended care facility (n=51), on the basis of demographic characteristics, functional indices, and neurological assessment on admission to rehabilitation. Other factors taken into account included past medical history and social support system. Univariate odds ratios were determined for neurological findings on admission, and for gender and marital status. Parametric analysis was used to compare groups for age at onset of stroke and for length of rehabilitation hospitalization. All significant findings were then loaded into a stepwise logistic regression model. Four factors explained 70% of the variance in discharge disposition: admission self-care assessment, presence of a spouse or significant other, history of cardiovascular disease, and presence of a visual field deficit. It is expected that the use of this system will allow for better predictions of the ultimate disposition and functional potential of middle band stroke patients.
