Factors That Relates to the Destination of Cerebral Infarction Patients in Acute Hospital

抄録

Purpose: We aimed to clarify the factors associated with transfer of cerebral infarction patients in the acute stage to rehabilitation hospitals. Subjects: From 277 consecutive patients admitted with cerebral infarction to the Stroke Center of our hospital, we chose 215 patients discharged to home (home-discharged group, n = 121) or to rehabilitation hospitals (rehabilitation hospital group, n = 94). We designed this study as a retrospective observational study and investigated various factors including social factors obtained from medical records. Results: Compared with the home-discharged group, the rehabilitation hospital group did not show differences in patient background, such as presence of housemates and numbers of persons per household but did show greater dysfunction and disability. Factors associated with discharge destination by multiple logistic regression analysis included the National Institute of Health Stroke Scale (NIHSS), when the illness is serious; the Ability for Basic Movement Scale II (ABMS II), when a wheelchair is first used; higher brain dysfunction; and the Barthel Index at the start of rehabilitation. From the results of ROC curves, cutoff values for determining discharge direction were 3.5 points by the NIHSS and 21.5 points by the ABMS II. Conclusion: It is suggested that both the NIHSS and the ABMS II, which is an objective index for evaluating basic mobility, might be factors for early prediction of discharge to rehabilitation hospitals.