Hospitalization in Physical and Rehabilitation Medicine in a Stroke Patient in the Context of Acute Hospitals - Evolution of Function and Satisfaction with Quality of Life: A Pre COVID-19 Pandemic Analysis

Authors

  • Bruno Guimarães Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal http://orcid.org/0000-0002-4577-5753
  • José Barreto Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
  • Sónia Tomé Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
  • Vitor Costa Pereira Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
  • Luísa Pinto Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
  • Filipa Gouveia Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
  • Cristina Carvalho Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
  • Inês Táboas Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
  • Sofia Toste Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
  • Catarina Aguiar-Branco Departamento de Medicina Física e de Reabilitação, Centro Hospitalar Entre o Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal

DOI:

https://doi.org/10.25759/spmfr.425

Keywords:

Hospitalization, Length of Stay, Patient Satisfaction, Quality of Life, Stroke, Stroke Rehabilitation

Abstract

Introduction: Stroke is the pathology with the highest mortality in Portugal. This study aims to analyze the functional evolution and the assess satisfaction with quality of life of stroke cases hospitalized in PRM acute hospital unit.

Methods: This study is a retrospective cohort, analyzing data between 2017 and 2019, referring to inpatients in the PRM department. 106 patients whose diagnosis on admission was stroke were evaluated (divided into ischemic stroke (IS) and hemorrhagic stroke (HS) groups). Participants were characterized in terms of different variables, namely the characterization of functional status at admission (FIM). Also the quality of life using the Satisfaction with Life Scale (SWLS) was assessed. Finally, multiple linear regression models were performed in order to determine which factors had an impact on functional improvement in stroke cases.

Results: Of the 106 patients, 76 were IS (72%) and 30 were HS (28%). The HS group had younger patients compared to the IS group (67.57 ± 11.41 vs 58.33 ± 11.33, p<0.001). There were no statistically significant differences between the IS and HS groups in terms of length of stay (pre-PRM length of stay: 13.66 ± 15.01 vs 11.53 ± 12.414, p=0.495; length of stay in PMR: 21 .74 ± 15.46 vs 22.10 ± 19.77, p=0.920; total length of stay: 35.39 ± 22.15 vs 33.63 ± 23.66, p=0.918), functional status at admission (68 .19 ± 17.25 vs 73.42 ± 16.50, p=0.198). However, there is a difference between the IS and HS groups regarding the functional status at clinical discharge (79.64 ± 19.67 vs 98.10 ± 20.04, p<0.001), as well as in the degree of improvement during the hospital stay (11.38 ± 7.08 vs 26.88 ± 14.40, p<0.001). A positive correlation of functional status at clinical discharge with the diagnosis of HS (β = 13.35, p=2.442) and with age (β = -0.268, p= 0.006). Finally, differences were found between the IS and HS groups in terms of satisfaction with quality of life (20.01 ± 5.33 vs 23.88 ± 6.07, p= 0.016).

Conclusion: The results of this study reflect the importance of considering different variables of stroke cases in PRM units.

Downloads

Download data is not yet available.

References

Sousa-Uva, M. and C.M. Dias, Prevalência de Acidente Vascular Cerebral na população portuguesa: dados da amostra ECOS 2013. 2014.

Feigin, V.L., et al., Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. The Lancet Neurology, 2009. 8(4): p. 355-369.

Thrift, A.G., et al., Global stroke statistics. International Journal of Stroke, 2014. 9(1): p. 6-18.

Van Peppen, R.P., et al., The impact of physical therapy on functional outcomes after stroke: what's the evidence? Clinical rehabilitation, 2004. 18(8): p. 833-862.

Winstein, C.J., et al., Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, 2016. 47(6): p. e98-e169.

Andersen, K.K., et al., Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors. Stroke, 2009. 40(6): p. 2068-2072.

Shiber, J.R., E. Fontane, and A. Adewale, Stroke registry: hemorrhagic vs ischemic strokes. The American journal of emergency medicine, 2010. 28(3): p. 331-333.

Trouillas, P. and R.d. von Kummer, Classification and pathogenesis of cerebral hemorrhages after thrombolysis in ischemic stroke. Stroke, 2006. 37(2): p. 556-561.

Mackay, J., The atlas of heart disease and stroke. Vol. 5. 2004: World Health Organization.

Lackland, D.T., et al., Factors influencing the decline in stroke mortality: a statement from the American Heart Association/American Stroke Association. Stroke, 2014. 45(1): p. 315-53.

Go, A.S., et al., Executive summary: heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation, 2014. 129(3): p. 399-410.

Tummers, J.F., A.J. Schrijvers, and J.M. Visser-Meily, Economic evidence on integrated care for stroke patients; a systematic review. Int J Integr Care, 2012. 12: p. e193.

Nadeau, S.E., et al., Effects of task-specific and impairment-based training compared with usual care on functional walking ability after inpatient stroke rehabilitation: LEAPS Trial. Neurorehabil Neural Repair, 2013. 27(4): p. 370-80.

Stucki, G., A. Cieza, and J. Melvin, The International Classification of Functioning, Disability and Health (ICF): a unifying model for the conceptual description of the rehabilitation strategy. J Rehabil Med, 2007. 39(4): p. 279-85.

Chung, D.M., et al., Predictors of discharge to acute care after inpatient rehabilitation in severely affected stroke patients. Am J Phys Med Rehabil, 2012. 91(5): p. 387-92.

Roberts, P.S., et al., Risk factors for discharge to an acute care hospital from inpatient rehabilitation among stroke patients. Pm r, 2014. 6(1): p. 50-5; quiz 55.

Bindawas, S.M., V. Vennu, and E. Moftah, Improved functions and reduced length of stay after inpatient rehabilitation programs in older adults with stroke: A systematic review and meta-analysis of randomized controlled trials. NeuroRehabilitation, 2017. 40(3): p. 369-390.

Safer, V.B. and B.F. Koseoglu, Timing of inpatient rehabilitation initiation in stroke patients: factors influencing early admission. J Phys Ther Sci, 2015. 27(6): p. 1913-7.

Salbach, N.M., et al., Facilitated interprofessional implementation of a physical rehabilitation guideline for stroke in inpatient settings: process evaluation of a cluster randomized trial. Implement Sci, 2017. 12(1): p. 100.

Chuluunbaatar, E., Y.J. Chou, and C. Pu, Quality of life of stroke survivors and their informal caregivers: A prospective study. Disabil Health J, 2016. 9(2): p. 306-12.

Published

2021-12-23

How to Cite

1.
Guimarães B, Barreto J, Tomé S, Pereira VC, Pinto L, Gouveia F, et al. Hospitalization in Physical and Rehabilitation Medicine in a Stroke Patient in the Context of Acute Hospitals - Evolution of Function and Satisfaction with Quality of Life: A Pre COVID-19 Pandemic Analysis. SPMFR [Internet]. 2021 Dec. 23 [cited 2024 Nov. 24];33(3):111-7. Available from: https://spmfrjournal.org/index.php/spmfr/article/view/425

Issue

Section

Original Article

Similar Articles

<< < 4 5 6 7 8 9 10 11 12 13 > >> 

You may also start an advanced similarity search for this article.