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Outcome Scores Predict Discharge Destination Post Stroke

For patients with acute or subacute stroke, outcome measure scores are associated with discharge destination, according to a review published in the January issue of the Journal of Neurologic Physical Therapy.

Emily R. Thorpe, DPT, from Walsh University in North Canton, Ohio, and colleagues conducted a systematic literature review of studies in three databases to examine the correlation between outcome measure scores and discharge destination in adults after acute or subacute stroke. Nine cohort studies were included in the systematic review and five in meta-analyses.

The researchers found that a patient was approximately 1.08 times more likely to be discharged home than to institutionalized care for every 1-point increase on the Functional Independence Measure (FIM) (odds ratio, 1.079). The likelihood of being discharged home was increased more than 12-fold for patients with stroke who performed above average (FIM ≥80; National Institutes of Health Stroke Scale (NIHSS) ≤5; odds ratio, 12.08). Patients who performed poorly (FIM ≤39; NIHSS score ≥14) were more likely to be discharged to institutionalized care than home (odds ratio, 3.385), with admission to skilled nursing facility more likely than to inpatient rehabilitation facility. Average performance (FIM = 40 to 79; NIHSS score = 6 to 13) was associated with a 1.9-fold increased likelihood of being discharged to institutionalized care (odds ratio, 1.879).

"Outcome measure scores are strong predictors of discharge destination among patients with stroke and provide an objective means of early discharge planning," the authors wrote.

Source: Health Day