Stroke Rehabilitation Continuity using a Liaison-clinical Pathway…Akihiro TOYOTA 117

A Regional Cooperation System Approach in Dementia Rehabilitation…Toshiomi ASAHI 123

Points at Issue for a Cooperative Regional Clinical System for Hip Fracture Treatment…Kaoru YAMAZAKI, Hiroki FURUHASHI 127

Community Cooperation and Liaison-clinical Pathways for Stroke and Hip Fracture at our Hospital…Shigeo OONO 130

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As a scholarly research activity using “the Japanese Association of Rehabilitation Medicine rehabilitation patient database”, we performed an analysis with the objective of clarifying the actual conditions of DVT in stroke patients. The subjects consisted of 345 stroke patients with DVT data from the “December 2010 version" of the database. In 9 of the 345 cases (2.6%), DVT complications were observed. No significant relevance among NIHSS, mRS, or the FIM score was found at the time of admission to hospital. In addition, no association with the number of days from the onset of PT (which is believed to be a related factor) and the onset of DVT was observed. For the acute condition change rate, the DVT complication group was observed to have a significantly high rate. Moreover, for the home recovery rate, the DVT complication group was observed to have a significantly low rate. Therefore, using only the severity of the condition at the time of admission and the length of the period until the commencement of rehabilitation, it is difficult to predict the onset of DVT, and it was shown that there is a danger of DVT occurring in any stroke patient. Furthermore, the acute condition change rate when DVT occurs as a complication is high. As a result, it is therefore necessary to be vigilant in the prevention and early diagnosis of DVT.

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The Japanese Association of Rehabilitation Medicine (JARM) is developing a Rehabilitation Patient Database (DB). The accumulated number of registered patients exceeded 10000 by March, 2011. The purposes of this article are to describe the process and procedures of secondary analysis and to consider potentials and limitations of the DB to promote the research activities of JARM members. JARM Members who submitted patient data or cooperate with JARM in the secondary analysis are regarded as eligible to use the combined data submitted by many hospitals. A suitable patient dataset should be derived from the DB including stroke, hip fracture, and spinal cord injury, and also patient data from the acute to recovery phase of rehabilitation. Additionally, before paper drafts can be submitted, a reviewing process is needed. The DB holds much potential, because the sample size is large and data were submitted from many hospitals. Since there are inherent limitations in all observational research, many issues such as endogeneities and confounders should be considered carefully to ensure high quality evidence is obtained with validity and reliability using the DB.

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