Article

The aim of this study was to examine the associations of onset days,
time from stroke onset to inpatient rehabilitation facility (IRF) admission, and
patient outcomes (FIM gain, discharge destination, and IRF length of stay), using
nationally representative data. DESIGN: A secondary data analysis was conducted
on a random sample of stroke patients discharged from IRFs in the United States
between 2009 and 2011, including mildly (n = 649), moderately (n = 2185), and
severely (n = 2390) impaired patients. RESULTS: The study sample had a median of
onset days of 5.5, with an interquartile range of 4-9. With the use of 15-365
days as reference, the severely impaired patients had a higher cognition gain (P
< 0.01) and were more likely to be discharged to the community (odds ratio, 1.45;
95% confidence interval, 1.12-1.87) when admitted within 7 days, a greater motor
gain when admitted within 14 days (P < 0.01), and a lower risk for acute hospital
transfer when admitted 3-7 days (odds ratio, 0.62; 95% confidence interval,
0.43-0.90). The moderately impaired patients had a greater motor gain when
admitted within 7 days (P < 0.01). Early IRF admission was also associated with a
shorter length of stay. CONCLUSIONS: Earlier IRF admission was beneficial among
severely and moderately impaired patients. IRF admission within 7 days is
recommended for stroke patients who achieved medical stability.

Langue : ANGLAIS