Javascript required
Skip to content Skip to sidebar Skip to footer
Home / Predictors of Inpatient Rehab Outcome Inadequate Family Support Elderly

Predictors of Inpatient Rehab Outcome Inadequate Family Support Elderly

  • Inquiry commodity
  • Open Access
  • Published:

Factors associated with successful home belch afterwards inpatient rehabilitation in fragile older stroke patients

  • Jolanda C. Grand. van Haastregt1,2,
  • Frans E. S. Tanii,three,
  • Gertrudis I. J. Grand. Kempenone,2,
  • Jos M. 1000. A. Scholsone,2 &
  • Jeanine A. Verbunt2,4,5

BMC Geriatrics volume 20, Commodity number:25 (2020) Cite this article

  • 2799 Accesses

  • viii Citations

  • 2 Altmetric

  • Metrics details

Abstract

Groundwork

Stroke is a highly prevalent illness amidst older people and tin can take a major affect on daily functioning and quality of life. When customs-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 nonetheless unable to return habitation after belch and has to exist admitted to a residential care setting. This written report aims to place which factors are associated with home belch after inpatient rehabilitation among frail and multimorbid older stroke patients.

Methods

This study is a longitudinal cohort written report among 92 community-domicile stroke patients anile 65 years or over. All patients were admitted to one of eight participating intermediate intendance facilities for geriatric rehabilitation, under the expectation to return home subsequently rehabilitation. We examined whether sixteen 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 remainder; daily activeness level; and independence in activities of daily living) measured at admission were associated with belch to the former living situation. Logistic regression analysis was used for statistical analysis.

Results

Hateful age of the patients was 79.0 years (SD six.iv) and 51.ane% was female. A total of 71 patients (77.one%) were discharged to the onetime living situation within 6 months after the start of geriatric rehabilitation. Of the sixteen factors analysed, only a higher level of independence in activities of daily living at admission was significantly associated with habitation discharge.

Conclusions

Our report shows that the vast majority of previously identified factors predicting dwelling discharge amid stroke patients, could not predict dwelling house discharge amidst a group of frail and multimorbid older persons admitted to geriatric rehabilitation. Merely a college level of independence in activities of daily living at admission was significantly related to home discharge. Boosted insight in other factors that might predict home discharge subsequently geriatric rehabilitation amongst this specific grouping of frail older stroke patients, is needed. Trial registration: ISRCTN ISRCTN62286281. Registered 19-three-2010.

Peer Review reports

Groundwork

Stroke is a highly prevalent affliction amongst older people and can accept a major impact on daily functioning and quality of life. The prevalence of stroke among Dutch people of 65 years or older is estimated at 54 per thousand males and 40 per 1000 females [1]. In the netherlands, later admission to a hospital, about 1 third of older stroke patients is referred to an intermediate care facility for (geriatric) rehabilitation, which is specifically aimed at the rehabilitation of frail and multimorbid community-abode older people [2].

In kingdom of the netherlands, admission to an intermediate care facility for geriatric rehabilitation is indicated for customs-abode delicate older people, who are expected to have the chapters to improve to a functional level that enables discharge to their erstwhile living state of affairs within a maximum of 6 months of rehabilitation [2]. However, adequately predicting functional recovery and home discharge for this group of older people is a challenge for care professionals, due to the multimorbidity and frailty of these patients. Every bit a result, ultimately up to 25% of these older stroke patients appears not to be able to return to their previous living situation subsequently geriatric rehabilitation [3]. Often, these patients are admitted to a nursing habitation or other residential care setting [4, v]. More than insight into factors associated with dwelling house discharge of fragile and multimorbid older stroke patients subsequently geriatric rehabilitation is needed to back up care professionals to brand an adequate prognosis of belch destination and to back up them to focus their treatment on increasing the chances of home belch.

Although various studies have assessed predictors of discharge destination of stroke patients, the number of studies conducted exclusively in frail and multimorbid stroke patients in geriatric rehabilitation is limited compared to the much larger body of literature performed amongst the general population of stroke patients.

However, studies amongst such fragile and multimorbid older patients admitted to intermediate care facilities for rehabilitation, show that the following factors are negatively associated with home belch; high age [5, half-dozen], female sex [seven], living alone [7,8,9,10], absence of social support [vii, 9,ten,xi], hemorrhagic stroke [vii], loss of conciousness [viii], cognitive inability [6,seven,8,9,10, 12], neglect [5, 7, viii], unawareness of disease [8], severe paralysis [8], spasticity [viii], urinary and bowel incontinence [half-dozen, 8, 10, 12], limited postural command [v], hemianopsia [viii], and dependence in activities of daily living [6,vii,8,9,x,xi]. Furthermore, in club to prevent missing potential relevant predictors of home discharge, we besides performed a quick scan of studies performed among the general population of stroke patients for additional factors related to home discharge later stroke rehabilitation [xiii,14,fifteen,16,17,18,19,20,21,22].

Based on these two groups of studies, five categories of factors measured at admission to rehabilitation are found to exist negatively correlated to home belch later rehabilitation of stroke patients:

  1. 1.

    Demographic characteristics: loftier age [v, 6, xiii, 14, 16, 17, nineteen, 20, 22], non-white race [13], female sex activity [7, thirteen, fourteen, 17].

  2. two.

    Social and environmental characteristics: living alone (i.e. non sharing a household) [7,viii,ix,10, 13,14,15, 17, 18, 21], absence of social support [7, 9,10,11, eighteen, xix], insufficient professional care [nineteen], loftier demand for home adaptations [19], and express private fiscal means [19].

  3. 3.

    Stroke related health status: stroke history [xiii, 17], hemorrhagic stroke [ seven, 13, 17], more severe stroke [2, xvi, 19, 22], larger stroke book [xiii, 14, xvi], loss of consciousness [8, 13, 16, 17, nineteen], cognitive inability [half dozen,7,8,9,10, 12,13,14,15,sixteen,17, 19], neglect [5, 7, 8, fourteen, 16, 17, 19], apraxia [16, 17, 19], unawareness of illness [8, xiv, 17], severe paralysis [8, 14, 16, 17, 19], impairment in motility [17, 19, 20] spasticity [eight], disorientation in time and identify [16, 17, xix], emotional problems [13, 19], dysphagia [xv, 16], urinary and bowel incontinence [6, eight, 10, 12, thirteen, fifteen,sixteen,17, 19], express postural control [five], restrictions in sitting balance [16, 19], and hemianopsia [8, xvi, 17].

  4. 4.

    General wellness status: high blood pressure [13, 16], diabetes mellitus [13], pneumonia [xiii], cardiovascular disorders [xiii, xvi], multimorbidity [13, 16], personality disorder [19].

  5. five.

    Functional condition: communication disability [nineteen], depression daily action level [13], dependence in activities of daily living [six,seven,8,9,10,eleven,12,13, xvi, 17, 19,20,21].

The factors that were found to exist related to home discharge in at least five of our selected studies were dependence in activities of daily living (n = 13 studies), cerebral disability (n = 12), living solitary (due north = 10), high age (due north = ix), urinary and bowel incontinence (north = 9), fail (n = 7), absence of social support (northward = 6), loss of consciousness (due north = 5), and severe paralysis (n = 5). Due to the large number of (potential) predictors of home discharge reported in literature, information technology is important for care professionals in intermediate care facilities for geriatric rehabilitation to gain insight in which factors most strongly correlate with domicile discharge amidst frail and multimorbid older stroke patients.

Therefore, the aim of this report is to identify which factors are associated with home discharge later on inpatient rehabilitation among frail and multimorbid older stroke patients. For this purpose, in our report we take combined a fix of factors previously establish to be related to dwelling discharge, in social club to gain insight in the factors most strongly correlating with home discharge of frail and multimorbid stroke patients after inpatient geriatric rehabilitation.

Methods

Blueprint

Nosotros performed a longitudinal cohort study, based on information from the MAESTRO-written report [23] which is a two group multicenter randomized controlled trial evaluating the effects of a new geriatric rehabilitation program for older people with stroke admitted to an intermediate intendance facilities for geriatric rehabilitation. For this secondary analysis we used data of the patients allocated to the control group, who received usual care based on the Dutch guidelines for stroke rehabilitation [24]. Patients from the experimental group were excluded considering of the possible intervention upshot.

Report sample

The sample for this report consisted of 92 persons admitted to an intermediate care facility for geriatric rehabilitation in the period Nov 2010 to Dec 2014. Inclusion criteria for these patients were: (ane) age 65 year or older, (2) living independently in the community before stroke, and (three) beingness admitted to one of eight intermediate care facilities for geriatric rehabilitation in the s of the Netherlands nether the prognosis that they would exist able to return to their previous living situation after rehabilitation (as assessed 2 weeks afterward admission by clinical sentence of a multidisciplinary team at the intermediate care facility for geriatric rehabilitation). Patients, who were medically unstable or had severe cognitive disabilities and were unable to start rehabilitation, were excluded23. Informed consent was obtained from all participants. The study protocol has been approved by the medical ethics committee of Maastricht University Medical Centre (MUMC+), kingdom of the netherlands (ISRCTN62286281, NTR2412). The study protocol has been published elsewhere [23].

Data drove

Data were gathered by ways of registration forms administered by intendance professionals of the intermediate care facility for geriatric rehabilitation and structured interviews with patients [23]. The interviews with the patients were conducted by trained research administration at the showtime of the rehabilitation treatment.

Factors measured at admission to the intermediate intendance facility for geriatric rehabilitation

All potential predictors of dwelling discharge of stroke patients after rehabilitation (described above) that were also measured in the MAESTRO report were selected for the present study. The last fix of potentially predictive factors was divided in the five categories mentioned earlier: demographic characteristics, social and environmental factors, stroke related health status, full general health status and functional status as presented beneath. The following 16 factors assessed at admission to the intermediate automobile facility for geriatric rehabilitation were available in the MAESTRO-dataset:

  1. ane.

    Demographic characteristics: age, sex;

  2. ii.

    Social characteristics: household state of affairs before access (living alone or with others);

  3. 3.

    Stroke related health status: stroke history, cerebral disability, neglect, apraxia, dysphagia, urinary and bowel incontinence, and sitting balance;

  4. 4.

    General wellness status: emotional issues, cardiovascular disorders, diabetes mellitus, multimorbidity;

  5. 5.

    Functional status: daily activity level, independence in activities of daily living.

Stroke history, neglect, apraxia, urinary and bowel incontinence, sitting residuum, cardiovascular disorders and diabetes mellitus, were retrieved from patient records and dichotomized (nowadays or non present). Information regarding household state of affairs before admission (i.e. living solitary or sharing a household with ane or more persons) was assessed by ways of the interview with the patient at admission to geriatric rehabilitation. In the same interview, also the factors emotional problems, multimorbidity, daily activeness level, independence in activities of daily living and cognitive disability were assessed. Emotional problems were measured by the emotional issues domain of the EuroQol-5D (EQ-5D) [25]. This detail was dichotomized in (0) no emotional problems, and (1) emotional problems. Multimorbidity was measured by a variable which included 17 unlike medical conditions which are scored as nowadays (1) or not nowadays (0) [26]. The summed multimorbidity score can range from 0 to 17 with higher scores indicating more atmospheric condition nowadays. Daily activeness level was measured past the Frenchay Action Index (FAI) [27]. The FAI measures the daily action level of stroke patients and consists of fifteen items (range 15–sixty with higher scores indicating better operation). The level of independence in activities of daily living was assessed with the Katz Index of Independence in Activities of Daily Living scale (Katz-15) [28] consisting of 15 items (range 0–fifteen with lower scores indicating a higher level of independence). Cerebral status was measured by the xi-item Minimal Mental State Examination (MMSE; range 0–30 with college scores indicating ameliorate functioning) [29].

Discharge destination

Data regarding the living state of affairs 6 months later on admission (moment of belch) to geriatric rehabilitation were gathered from the discharge registration of the eight participating rehabilitation units. The available data were dichotomized into (1) discharged to the previous living situation (i.due east. home discharge) and (0) not discharged to the previous living state of affairs (i.e. nevertheless in geriatric rehabilitation or admitted to nursing home, intendance home or service apartment).

Statistical analysis

Outset, descriptive statistics were used to calculate means or proportions of the potential prognostic factors. Second, a Pearson R correlation analysis was applied to assess strength of the univariate human relationship betwixt the potential prognostic factors, and discharge destination. For some chiselled factors (i.e. gender, household situation, apraxia, fail, dysphagia) a chi-square examination was applied. Pearson correlation is a measure of strength, whereas Ch-square is a test statistics. All categorical variables are dichotomous. Thus a Pearson correlation can be calculated (instead of phi coefficient; they are exactly the aforementioned). Third, a two-level logistic regression analysis was conducted to study the relationship between the potential prognostic factors and belch destination. The beginning level consists of the patients and the second level consists of the organizations, because the patients are nested inside the organizations. In each step of the analysis the gene with the highest p-value was eliminated until only factors remained with a p-value below 0.10. The association of each individual variable was expressed in an odds ratio, 95% conviction interval, and p-value. All statistical analyses were conducted using SPSS software version 25 for Windows.

Results

Patient characteristics measured at baseline are presented in Table 1. The mean historic period of the patients was 79.0 (SD 6.4) twelvemonth with a range of 65 to 94 years. Most half of the patients (n = 47, 51.1%) were female person and 43 patients (47.3%) lived alone before access. On average, the patients had 4 different medical atmospheric condition. Later on 6 months 71 patients (77.ane%) had returned to their sometime living situation, and 21 (22.8%) patients were admitted to sheltered housing or nursing home run into Table 2).

Table 1 Patient characteristics measured at baseline (north = 92)

Full size table

Table 2 Discharge destination of the patients later on 6 months

Full size table

Table 3 presents the bivariate correlations between the 16 included prognostic factors and discharge destination. The analysis shows that only i of the sixteen potential prognostic factors, independence in activities of daily living, is significantly related to dwelling discharge (r = − 0.38, p = 0.00). The logistic regression analysis presented in Table 4 as well shows that merely a higher level of independence in activities of daily living is significantly related to home discharge (OR = 0.70, p = 0.01).

Table 3 Bivariate Correlation analyses of predictive factors and discharge to onetime living situation

Full size tabular array

Table 4 Logistic regression analyses of associated home discharge predictors

Full size table

Give-and-take

In the Netherlands, specialized intermediate intendance facilities for geriatric rehabilitation aim to enable customs-living fragile older stroke patients to return to their previous living situation after rehabilitation. Nevertheless, due to the complex nature of stroke, and the frailty level of these older multimorbid stroke patients (equally indicated by the average number of four medical conditions), predicting functional recovery and discharge destination are considered very challenging.

In the nowadays report, we examined 16 factors that, based on the literature, might be potentially associated with discharge destination of older stroke patients admitted to geriatric rehabilitation. These potential prognostic factors were: age; sex; household state of affairs before access; stroke history; cognitive disability; neglect; apraxia; dysphagia; urinary and bowel incontinence; emotional problems; cardiovascular disorders; diabetes mellitus; multimorbidity; sitting balance; daily activity level; and independence in activities of daily living. A two-level multivariable logistic regression analysis revealed that just a higher level of independence in activities of daily living at access (as measured with Katz-xv) was significantly associated with being discharged to the one-time living situation inside 6 months after admission to geriatric rehabilitation. The fifteen other factors were non significantly associated with habitation discharge.

Our results regarding the relationship between level of independence in activities of daily living at admission and discharge destination afterwards rehabilitation are in accordance with results of previous studies in the general population of stroke patients [13, 16, 17, 19,twenty,21] and among older stroke patients [6,7,viii,9,10,11,12], which showed that independence in activities of daily living was the virtually frequently mentioned predictor in the studies included in our literature search.

Yet, for the other 15 prognostic factors, no significant clan with discharge destination in our sample of frail and multimorbid older stroke patients could be identified. This is rather unexpected, because a pregnant human relationship of these prognostic factors with discharge destination was observed in one or more previous studies among the full general and/or older population of stroke patients [v,6,7,8,nine,x, 12,13,14,15,xvi,17,xviii,19,20,21,22].. The fact that our findings are inconsistent with current literature tin be explained by several factors. Starting time, nosotros also included prognostic factors in our assay that were only reported in studies amidst the general population of stroke patients (i.due east. apraxia, dysphagia, sitting rest, emotional problems, cardiovascular disease, diabetes mellitus, and daily activity level). It is likely that our sample of geriatric rehabilitation patients is considerably more complex compared to the general population of stroke patients because geriatric rehabilitation patients are often frail, multimorbid and may likewise accept a weaker social network, and so there might exist other prognostic factors present which tin can potentially influence the chances of home discharge. Nevertheless, the majority of prognostic factors included in our analyses were (besides) reported by studies amidst the population of older stroke patients who received rehabilitation in an intermediate care facility. A second possible explanation is that there are considerable differences betwixt our study sample and the samples of the majority of these other studies. Our study sample consisted of fragile and multimorbid stroke patients, and it is unclear whether studies performed in other countries included a comparable delicate and multimorbid population. In addition, in the Netherlands people with severe cerebral impairments (such equally dementia) are in general not admitted to geriatric rehabilitation due to a lack of trainability. It is possible that in countries where persons with severe cognitive impairments can be admitted to geriatric rehabilitation, cognitive impairment might be a statistically significant predictor of dwelling discharge.

A third explanation might be the fact that some of the prognostic factors included in our study, are measured in a dissimilar mode compared to previous studies. Instruments tin can differ for example with regard to their sensitivity or with regard to the specific aspects of the aforementioned phenomenon they assess, which might have resulted in different correlations.

This study has several limitations. Beginning, several prognostic factors were measured in a dichotomous way, such equally sitting remainder, apraxia and neglect, which may accept resulted in some loss of information. It is possible that a more than comprehensive way of assessing these factors would have led to other results in our assay. Second, this study is a secondary analysis of existing data. For this reason, nosotros were not able to include all potential relevant predictors of dwelling house belch in our study found in previous studies among older patients admitted to intermediate care facilities for rehabilitation, including social support [7, 9,10,eleven], hemorrhagic stroke [ 7], loss of consciousness [viii], unawareness of illness [viii], severe paralysis [8], spasticity [viii], postural control [five], and hemianopsia [half-dozen,7,8,nine,ten,11]. Almost of these factors were only establish in one single or a few studies, however social support was found in 6 other studies, and loss of consciousness and astringent paralysis in 5 studies, so information technology remains unclear whether these factors might besides be relevant predictors in our frail population. Although household state of affairs (i.eastward. living alone versus living with others) might exist considered an indicator of social back up information technology seems likely that this variable does not differentiate enough within our frail population.

Virtually half (47%) of our population lives alone, and probably a considerable number of the other half has a partner who is besides frail and needs support. Therefore, in a frail and multimorbid population, it might be amend to appraise the availability of informal caregivers, and social support in a more comprehensive fashion. Therefore, it is possible that nosotros missed some relevant prognostic factors especially in the domain of social support. Furthermore, researchers in the domain of stroke rehabilitation in fragile older people might have collectively missed or understudied potential relevant prognostic factors for dwelling belch, such every bit the level of frailty, (post stroke) depression, availability of family unit caregivers and/or professional caregivers, motivation and preferences of patients and family caregivers, and financial means. A tertiary limitation is the size of our sample. Although bivariate analyses revealed that only a college level of independence in activities of daily living at admission was significantly related to home discharge, for the logistic regression analyses our sample size tin exist considered relatively minor in relation to the relatively large number of prognostic factors in our logistic regression. However, bivariate analysis also revealed no significant correlations between the other prognostic factors and discharge destination. A 4th limitation is the fact that our study is performed in only one country (the Netherlands). Information technology is possible that due to cultural differences and/or differences in healthcare systems, in other countries different factors might be relevant for home discharge later stroke rehabilitation among frail older persons.

Conclusion

In decision, our study shows that the vast majority of prognostic factors reported in literature to be related to dwelling house belch among stroke patients after rehabilitation, were not correlated to home discharge within our study sample of frail and multimorbid older persons admitted to geriatric rehabilitation. Our analyses showed that only a higher level of independence in activities of daily living at admission to geriatric rehabilitation is associated with belch to the former living situation, 6 months later starting stroke rehabilitation. It is of import to gain boosted insight in possible other factors that might predict home discharge amidst frail older stroke patients later on geriatric rehabilitation, such equally the level of frailty, factors related to social back up, the availability of family and/or caregivers, and motivational factors.

Availability of information and materials

The datasets used and/or analysed during the current report are bachelor from the corresponding author on reasonable request.

References

  1. Vaartjes I, Bots ML, Poos MJJC. Hoe vaak komt een beroerte voor en hoeveel mensen sterven eraan? In: Volksgezondheid Toekomst Verkenning, Nationaal Kompas Volksgezondheid. Bilthoven: RIVM, 2014.

    Google Scholar

  2. Behandelkaders Geriatrische Revalidatie, Verenso 2010.

  3. The Influence of Activity-Based Funding on Treatment Intensity and Length of Stay of Geriatric Rehabilitation Patients. Bouwstra H, Wattel LM, de Groot AJ, Smalbrugge M, Hertogh CM. J Am Med Dir Assoc. 2017 Jun one;eighteen(six):549.e15-549.e22.

  4. Buijck BI, Zuidema SU, Spruit-van Eijk M, Geurts Air conditioning, Koopmans RT. Neuropsychiatric symptoms in geriatric patients admitted to skilled nursing facilities in nursing homes for rehabilitation later on stroke: a longitudinal multicenter study. Int J Geriatr Psychiatry. 2012 Jul;27(vii):734-41.

  5. Spruit-van Eijk M, Zuidema SU, Buijck BI, Koopmans RT, Geurts AC. Determinants of rehabilitation issue in geriatric patients admitted to skilled nursing facilities later on stroke: a Dutch multi-centre cohort report. Age Ageing. 2012 November;41(six):746-52.

  6. Thommessen B, Bautz-Holter E, Laake K. Predictors of issue of rehabilitation of elderly stroke patients in a geriatric ward. Clin Rehabil. 1999 Apr;xiii(two):123-eight.

  7. Mutai H, Furukawa T, Araki G, Misawa K, Hanihara T. Factors associated with functional recovery and home belch in stroke patients admitted to a ambulatory rehabilitation ward. Geriatr Gerontol Int. 2012 Apr;12(2):215-22.

  8. Kalra 50, Smith DH, Crome P. Stroke in patients aged over 75 years: result and predictors. Postgrad Med J. 1993 Jan;69(807):33-6.

  9. Denti 50, Agosti M, Franceschini M.Outcome predictors of rehabilitation for start stroke in the elderly. Eur J Phys Rehabil Med. 2008 Mar;44(ane):3-11.

  10. Gialanella B, Santoro R, Ferlucci C. Predicting outcome later stroke: the role of basic activities of daily living predicting outcome after stroke. Eur J Phys Rehabil Med. 2013 October;49(5):629-37.

  11. Lindenberg Thousand, Nitz JC, Rahmann A, Bew P. Predictors of discharge destination in a geriatric population after undergoing rehabilitation. J Geriatr Phys Ther. 2014 Apr-Jun;37(2):92-8.

  12. Ergeletzis D, Kevorkian CG, Rintala D. Rehabilitation of the older stroke patient: functional event and comparison with younger patients. Am J Phys Med Rehabil. 2002;81(12):881–9.

  13. Almenkerk Sv, Smalbrugge M, Depla MF, Eefsting JA, Hertogh CM. What predicts a poor outcome in older stroke survivors? A systematic review of the literature. Disabil Rehabil. 2013 Oct;35(21):1774-82.

  14. Jehkonen Thousand, Ahonen JP, Dastidar P, Koivisto AM, Laippala P, Vilkki J, Molnár Thou. Predictors of discharge to home during the offset year subsequently right hemisphere stroke. Acta Neurol Scand. 2001 Sep;104(3):136-41.

  15. Massucci M, Perdon L, Agosti M, Celani MG, Righetti E, Recupero E, Todeschini E, Franceschini M; Italian Cooperative Inquiry (ICR2). Prognostic factors of action limitation and discharge destination later stroke rehabilitation. Am J Phys Med Rehabil. 2006 Dec;85(12):963-70.

  16. Meijer R, Ihnenfeldt DS, de Groot IJ, van Limbeek J, Vermeulen Yard, de Haan RJ. Prognostic factors for ambulation and activities of daily living in the subacute phase after stroke. A systematic review of the literature. Clin Rehabil. 2003 Mar;17(ii):119-29.

  17. Meijer R, Ihnenfeldt DS, van Limbeek J, Vermeulen M, de Haan RJ. Prognostic factors in the subacute phase after stroke for the future residence later on six months to 1 twelvemonth. A systematic review of the literature. Clin Rehabil. 2003 Aug;17(v):512-xx.

  18. Meijer R, van Limbeek J, Kriek B, Ihnenfeldt D, Vermeulen Grand, de Haan R. Prognostic social factors in the subacute stage after a stroke for the discharge destination from the hospital stroke-unit. A systematic review of the literature. Disabil Rehabil. 2004 Feb 18;26(4):191-7.

  19. Meijer R, van Limbeek J, Peusens G, Rulkens M, Dankoor K, Vermeulen Chiliad, de Haan RJ. The Stroke Unit of measurement Discharge Guideline, a prognostic framework for the belch issue from the infirmary stroke unit. A prospective cohort study. Clin Rehabil. 2005 Oct;xix(7):770-eight

  20. Sánchez-Blanco I, Ochoa-Sangrador C, López-Munaín L, Izquierdo-Sánchez Grand, Fermoso-Garcia J. Predictive model of functional independence in stroke patients admitted to a rehabilitation programme. Clin Rehabil. 1999 December;13(half dozen):464-75.

  21. Wilson DB, Houle DM, Keith RA. Stroke rehabilitation: a model predicting render home.West J Med. 1991 May;154(5):587-ninety.

  22. Burton JK, Ferguson EEC, Barugh AJ, Walesby KE, MacLullich AMJ, Shenkin SD, Quinn TJ. Predicting Discharge to Institutional Long-Term Care After Stroke: A Systematic Review and Meta analysis. J Am Geriatr Soc. 2018 Jan;66(i):161-169.

  23. Vluggen TP, van Haastregt JC, Verbunt JA, Keijsers EJ, Schols JM. Multidisciplinary transmural rehabilitation for older persons with a stroke: the design of a randomised controlled trial. BMC Neurol. 2012 December 31;12:164.

  24. Richtlijn 'Diagnostiek, behandeling en zorg voor patiënten met een beroerte'. Kwaliteitsinstituut voor de gezondheidszorg CBO 2008.

  25. Krabbe PF, Stouthard ME, Essink-Bot ML, Bonsel GJ. The effect of calculation a cognitive dimension to the EuroQol multiattribute health-status classification arrangement. J Clin Epidemiol. 1999 Apr;52(4):293-301.

  26. Lutomski JE, Baars MAE, Schalk BWM, Boter H, Buurman BM, den Elzen WPJ, et al. (2013) The Development of the Older Persons and Breezy Caregivers Survey Minimum DataSet (TOPICS-MDS): A Large-Calibration Data Sharing Initiative. PLoS 1 8(12): e81673.

  27. Schuling J, de Haan R, Limburg M, Groenier KH. The Frenchay Activities Index. Assessment of functional condition in stroke patients. Stroke. 1993 Aug;24(8):1173-vii.

  28. Weinberger M, Samsa GP, Schmader G, Greenberg SM, Carr DB, Wildman DS. Comparison proxy and patients' perceptions of patients' functional status: results from an outpatient geriatric clinic. J Am Geriatr Soc. 1992 Jun;xl(6):585-8.

  29. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A applied method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189-98.

Download references

Acknowledgements

We would like to thank patients and informal caregivers, the care professionals and care organizations for participating in this written report. Furthermore, we acknowledge the care professionals who participated in developing the intervention. Additionally, we would like to thank the research assistants who contributed in the information collection, and our funder the Netherlands Organisation for Health Research and Evolution (ZonMw) for their grant to brand this study possible.

Funding

This study is funded with a grant (grant number:313070301) from kingdom of the netherlands Organisation for Wellness Inquiry and Development (ZonMw) equally office of the National Care for the Elderly Programme, which aims to ameliorate the quality of care for elderly persons past means of developing integrated health intendance that is adjusted to the individual needs of the elderly persons. The funder was not involved in the blueprint of the study, data collection, analysis, interpretation of data and in writing the manuscript.

Author information

Affiliations

  1. Department of Wellness Services Research, Maastricht University, PO Box 616 6200, Doctor, Maastricht, The Netherlands

    Tom P. K. M. Vluggen, Jolanda C. 1000. van Haastregt, Gertrudis I. J. G. Kempen & Jos M. G. A. Schols

  2. Care and Public Health Research Establish (CAPHRI), Maastricht University, Maastricht, Kingdom of the netherlands

    Tom P. M. Yard. Vluggen, Jolanda C. K. van Haastregt, Frans Due east. S. Tan, Gertrudis I. J. M. Kempen, Jos M. Grand. A. Schols & Jeanine A. Verbunt

  3. Department of Methodology and Statistics, Maastricht University, Maastricht, The netherlands

    Frans E. Southward. Tan

  4. Adelante, Eye of Expertise in Rehabilitation and Audiology, Hoensbroek, Holland

    Jeanine A. Verbunt

  5. Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands

    Jeanine A. Verbunt

Contributions

Television, JvH, FT, GK, JS and JV were involved in the pattern of the study, data drove, and data analysis. TV wrote drafts of the manuscript. JvH supervised data analysis. JvH, FT, GK, JS and JV were involved in the estimation of the results. JvH, JV, and JS supervised the project. All authors read, critically reviewed and approved the concluding manuscript.

Corresponding author

Correspondence to Tom P. M. Thou. Vluggen.

Ideals declarations

Ethics approval and consent to participate

Ethical apporoval was provided by the medical ethics commission of Maastricht Academy Medical Centre (MUMC+), kingdom of the netherlands (ISRCTN62286281, NTR2412). All participants gave written informed consent to accept role in the written report.

Consent for publication

Not applicative.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Admission This commodity is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Eatables Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/i.0/) applies to the data made available in this article, unless otherwise stated.

Reprints and Permissions

Well-nigh this article

Verify currency and authenticity via CrossMark

Cite this article

Vluggen, T.P.K.M., van Haastregt, J.C.Thou., Tan, F.E.S. et al. Factors associated with successful home discharge later inpatient rehabilitation in delicate older stroke patients. BMC Geriatr xx, 25 (2020). https://doi.org/x.1186/s12877-020-1422-half dozen

Download commendation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI : https://doi.org/x.1186/s12877-020-1422-6

Keywords

  • Stroke
  • Rehabilitation
  • Older people
  • Prediction
  • Discharge destination
  • Customs

frodshamthelly.blogspot.com

Source: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-020-1422-6