Article

We carried out a prospective study to determine whether stroke patients'
functional status or health-related quality of life would predict whether they
lived at home 2.5 years after discharge from neurological inpatient
rehabilitation. We carried out a single-center prospective cohort study. The
outcome 'home care' versus 'death' or 'institutionalization' (nursing home
admission) was evaluated 30 months after discharge. A total of 204 stroke
survivors with remaining moderate to severe functional deficits at admission to
neurological inpatient rehabilitation were included. Clinical data were obtained
at admission to and/or discharge from inpatient rehabilitation. Functional status
was determined using the Barthel Index; health-related quality of life was
assessed using the SF-36 and EQ-5D. The outcome was assessed by telephone
interview. Predictors of living at home were calculated using binary logistic
regression analysis. In total, 30 months after discharge, 75% of the stroke
survivors were still living at home. Multivariate analysis showed that patients
continued to live at home significantly more frequently when they had fewer
mortality-relevant comorbidities (P=0.001), a higher BMI (P=0.040), a higher
increase in functional independence during inpatient rehabilitation (P=0.017),
and above all, a better health-related quality of life, measured using the EQ-5D
(P<0.001), at discharge. Stroke survivors' health-related quality of life
measured with the EQ-5D and the change in functional status during multimodal
neurological rehabilitation appear to be the strongest clinically relevant
long-term predictors of staying at home.

Langue : ANGLAIS