頁籤選單縮合
題名 | Functional Recovery of Stroke Patients with Postacute Care: A Retrospective Study in a Northern Medical Center= |
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作者 | Huang, Hui-chi; Tsai, Jui-yao; Liu, Tzu-ching; Sheng, Wen-yung; Lin, Tzu-chun; Lin, Ching-wei; Lee, I-hui; Chung, Chih-ping; |
期刊 | Journal of the Chinese Medical Association |
出版日期 | 20190500 |
卷期 | 82:5 2019.05[民108.05] |
頁次 | 頁424-427 |
分類號 | 419.73 |
語文 | eng |
關鍵詞 | Postacute care; Stroke; Taiwan; |
英文摘要 | Background: Taiwan’s NHI Administration proposed a nationwide postacute care-cerebral vascular disease (PAC-CVD) program, which transfers stroke patients at postacute phase in medical centers to community hospitals. Its aim is mainly to prevent a prolonged stay in medical centers, which usually results in higher medical costs. The present study evaluated the 3-months functional outcomes of stroke patients receiving PAC-CVD. Methods: We retrogradely retrieved patients’ data from Stroke Registry of a Northern medical center. Patients admitted between January 2014 and March 2018 were screened. We included patients receiving PAC-CVD and age/sex/stroke severity/functional status-matched acute stroke patients (regular rehabilitation group). Baseline clinical characteristics and 3-months functional outcomes were analyzed. We defined 3-months mRS 0 to 2 as better, 3 to 4 as same, and 5 to 6 as worse functional recovery. Results: One-hundred-and-seventy-three patients receiving PAC-CVD and 173 matched controls (68.2 ± 14.0-years-old, 68.5% ± 11.22% men) were recruited. All patients were with mRS 3 to 4 at discharge from our medical center. The distributions of 3-months functional recovery in two groups were as follows: better/same/worse 3-months functional outcomes, PAC-CVD = 40.4%/57.8%/1.8%; controls (regular rehabilitation) = 33.9%/50.3%/5.8%. Multivariate analyses adjusted for age, sex, NIHSS, and cardiovascular risk factors were performed to evaluate whether PAC-CVD predicted better or poor functional outcomes. The results showed that compared with controls, PAC-CVD group had similar frequency of better functional recovery (odds ratio [OR] = 0.97, 95% CI = 0.54-1.74, p = 0.924) but less frequency of worse functional outcomes (OR = 0.08, 95% CI = 0.08-0.84, p = 0.035). Conclusion: About one-third of patients with mRS 3 to 4 recovered well in 3-months after stroke in both PAC-CVD and regular rehabilitation groups. Our results showed that PAC-CVD program can significantly decrease functional decline after acute stroke. |
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