Poststroke Disposition and Associated Factors in a Population-Based Study The Dijon Stroke Registry

被引:47
作者
Bejot, Yannick [1 ]
Troisgros, Odile [2 ]
Gremeaux, Vincent [2 ]
Lucas, Brigitte [3 ]
Jacquin, Agnes [1 ]
Khoumri, Catia [1 ]
Aboa-Eboule, Corine [1 ]
Benaim, Charles [2 ]
Casillas, Jean-Marie [2 ]
Giroud, Maurice [1 ]
机构
[1] Univ Hosp, Dept Neurol, EA4184, Dijon Stroke Registry, Dijon, France
[2] Univ Hosp Dijon, Dept Rehabil, Dijon, France
[3] Divio Hosp, Dept Rehabil, Dijon, France
关键词
epidemiology; registry; rehabilitation; stroke delivery; HOSPITAL DISPOSITION; REHABILITATION; DISPARITIES; ADMISSION; ACCESS; SCALE; HOME;
D O I
10.1161/STROKEAHA.112.658724
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-The organization of poststroke care will be a major challenge in coming years. We aimed to assess hospital disposition after stroke and its associated factors in clinical practice. Methods-All cases of stroke from 2006 to 2010 were identified from the population-based Stroke Registry of Dijon, France. Demographic features, risk factors, and prestroke treatments were recorded. Admission stroke severity was assessed using the National Institutes of Health Stroke Scale score. At discharge, we collected dementia, disability using the modified Rankin Scale, length of stay, and hospital disposition (home, rehabilitation, convalescent home, and nursing home). Multivariate analyses were performed using logistic regression models to identify associated factors of postdischarge disposition. Results-Of the patients with 1069 stroke included, 913 survived acute care. Among them, 433 (47.4%) returned home, whereas 206 (22.6%) were discharged to rehabilitation, 134 (14.7%) were admitted to a convalescent home, and 140 (15.3%) to a nursing home. Old patients, those under anticoagulants before stroke, those with severe stroke on admission, severe disability at discharge, dementia, or prolonged length of stay were less likely to return home. Moreover, advanced age, severe initial stroke, severe disability at discharge, and dementia were associated with admission to convalescent and nursing homes rather than rehabilitation centers. Conclusion-This population-based study demonstrated that postdischarge destinations are associated with several factors. Our findings may be useful to establish health policy concerning the organization of poststroke care. (Stroke. 2012;43:2071-2077.)
引用
收藏
页码:2071 / U106
页数:10
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