Tom P M M Vluggen1,2, Jolanda C M van Haastregt3,4, Frans E S Tan4,5, Gertrudis I J M Kempen3,4, Jos M G A Schols3,4, Jeanine A Verbunt4,6,7. 1. Department of Health Services Research, Maastricht University, PO Box 616 6200, MD, Maastricht, The Netherlands. t.vluggen@maastrichtuniversity.nl. 2. Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. t.vluggen@maastrichtuniversity.nl. 3. Department of Health Services Research, Maastricht University, PO Box 616 6200, MD, Maastricht, The Netherlands. 4. Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. 5. Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands. 6. Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands. 7. Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands.
Abstract
BACKGROUND: Stroke is a highly prevalent disease among older people and can have a major impact on daily functioning and quality of life. When community-dwelling older people are hospitalized due to stroke, discharge to an intermediate care facility for geriatric rehabilitation is indicated when return to the previous living situation is expected but not yet possible. However, a substantial proportion is still unable to return home after discharge and has to be admitted to a residential care setting. This study aims to identify which factors are associated with home discharge after inpatient rehabilitation among frail and multimorbid older stroke patients. METHODS: This study is a longitudinal cohort study among 92 community-dwelling stroke patients aged 65 years or over. All patients were admitted to one of eight participating intermediate care facilities for geriatric rehabilitation, under the expectation to return home after rehabilitation. We examined whether 16 potentially relevant factors (age; sex; household situation before admission; stroke history; cardiovascular disorders; diabetes mellitus; multimorbidity; cognitive disability; neglect; apraxia; dysphagia; urinary and bowel incontinence; emotional problems; sitting balance; daily activity level; and independence in activities of daily living) measured at admission were associated with discharge to the former living situation. Logistic regression analysis was used for statistical analysis. RESULTS: Mean age of the patients was 79.0 years (SD 6.4) and 51.1% was female. A total of 71 patients (77.1%) were discharged to the former living situation within 6 months after the start of geriatric rehabilitation. Of the 16 factors analysed, only a higher level of independence in activities of daily living at admission was significantly associated with home discharge. CONCLUSIONS: Our study shows that the vast majority of previously identified factors predicting home discharge among stroke patients, could not predict home discharge among a group of frail and multimorbid older persons admitted to geriatric rehabilitation. Only a higher level of independence in activities of daily living at admission was significantly related to home discharge. Additional insight in other factors that might predict home discharge after geriatric rehabilitation among this specific group of frail older stroke patients, is needed. TRIAL REGISTRATION: ISRCTN ISRCTN62286281. Registered 19-3-2010.
BACKGROUND:Stroke is a highly prevalent disease among older people and can have a major impact on daily functioning and quality of life. When community-dwelling older people are hospitalized due to stroke, discharge to an intermediate care facility for geriatric rehabilitation is indicated when return to the previous living situation is expected but not yet possible. However, a substantial proportion is still unable to return home after discharge and has to be admitted to a residential care setting. This study aims to identify which factors are associated with home discharge after inpatient rehabilitation among frail and multimorbid older strokepatients. METHODS: This study is a longitudinal cohort study among 92 community-dwelling strokepatients aged 65 years or over. All patients were admitted to one of eight participating intermediate care facilities for geriatric rehabilitation, under the expectation to return home after rehabilitation. We examined whether 16 potentially relevant factors (age; sex; household situation before admission; stroke history; cardiovascular disorders; diabetes mellitus; multimorbidity; cognitive disability; neglect; apraxia; dysphagia; urinary and bowel incontinence; emotional problems; sitting balance; daily activity level; and independence in activities of daily living) measured at admission were associated with discharge to the former living situation. Logistic regression analysis was used for statistical analysis. RESULTS: Mean age of the patients was 79.0 years (SD 6.4) and 51.1% was female. A total of 71 patients (77.1%) were discharged to the former living situation within 6 months after the start of geriatric rehabilitation. Of the 16 factors analysed, only a higher level of independence in activities of daily living at admission was significantly associated with home discharge. CONCLUSIONS: Our study shows that the vast majority of previously identified factors predicting home discharge among strokepatients, could not predict home discharge among a group of frail and multimorbid older persons admitted to geriatric rehabilitation. Only a higher level of independence in activities of daily living at admission was significantly related to home discharge. Additional insight in other factors that might predict home discharge after geriatric rehabilitation among this specific group of frail older strokepatients, is needed. TRIAL REGISTRATION: ISRCTN ISRCTN62286281. Registered 19-3-2010.
Authors: Mirjam R Heldner; Caroline Chalfine; Marion Houot; Roza M Umarova; Jan Rosner; Julian Lippert; Laura Gallucci; Anne Leger; Flore Baronnet; Yves Samson; Charlotte Rosso Journal: Front Neurol Date: 2022-02-17 Impact factor: 4.003
Authors: Jo-Aine Hang; Jacqueline Francis-Coad; Chiara Naseri; Angela Jacques; Nicholas Waldron; Kate Purslowe; Anne-Marie Hill Journal: Front Public Health Date: 2021-06-28