Article

OBJECTIVE: To identify patient-related factors that have been found to correlate
with functional outcomes post acute stroke to guide clinical decision making with
regard to rehabilitation admission after acute stroke. DATA SOURCES: We
systematically searched the scientific literature between 1966 and January 2010.
The primary source of studies was the electronic databases Medline, CINAHL, and
Embase. The search was supplemented with citation tracking. STUDY SELECTION: Two
reviewers independently applied the inclusion criteria to identify relevant
articles from the citations obtained through the literature search. Eligible
studies included systematic reviews of prognostic indicators, studies of
prognostic indicators of acute discharge disposition, and studies of
rehabilitation admission criteria after acute stroke.
Of the 8895 studies
identified, 83 articles, representing 79 studies, were included in the review.
DATA EXTRACTION: One reviewer extracted the data relating to the participants,
prognostic indicators, and outcomes. A second reviewer independently checked data
extracted with disagreement resolved by a third reviewer. Quality of included
studies was assessed for internal and external validity. DATA SYNTHESIS: Of the
79 studies, 26 were systematic reviews of prognostic indicators of functional
level and/or discharge disposition, 48 were studies of prognostic indicators of
acute discharge disposition, and 6 were studies of rehabilitation selection
criteria. The methodologic quality of the included studies was generally poor.
Age, cognition, functional level after stroke, and, to a lesser extent,
continence were found to have a consistent association with outcome across all 3
research areas. In addition, stroke severity was also associated with acute
discharge disposition, final discharge disposition, and functional level. Sex and
side of stroke appeared to have no association across all 3 of the research
areas. CONCLUSIONS: This review highlights a number of important prognostic
indicators and rehabilitation selection criteria that may assist clinicians in
improving selection procedures and standardizing access to inpatient
rehabilitation after stroke, although the quality of many studies is low. Further
high quality studies and reviews of prognostic indicators and clinician decision
making with regards to rehabilitation acceptance are required.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS